维吾尔族肺结核患者肝损害的发生率及相关因素的调查  

Study on the incidence and risk factors of liver injury in Uighur tuberculosis patients

作　　者：马晨晨[1] 翟啸虎[2] 秦丽岩[1] 顾佳怡[1] 毛英[1] 祖丽娅.沙塔尔 向阳[1] 

机构地区：[1]新疆医科大学流行病学与卫生统计学教研室,新疆乌鲁木齐830011 [2]新疆维吾尔自治区疾病预防控制中心计划免疫科,新疆乌鲁木齐830011

出　　处：《中华疾病控制杂志》2016年第1期17-20,共4页Chinese Journal of Disease Control & Prevention

基　　金：国家自然科学基金(30960328)

摘　　要：目的了解维吾尔族肺结核患者化疗中肝损害发生情况，探讨导致肝损害可能的危险因素，为今后结核病的治疗与控制提供一定的依据。方法采用巢式病例对照研究的方法，对新疆南疆某地区1135例维吾尔族患者进行随访及资料收集，对可能诱导抗结核药物性肝损害的相关因素进行统计分析和推论。结果抗结核药物所致肝损害（anti—tuberculosisdruginducedliverinjury，ATLI）的总发生率为3．08％。经单因素检验，既往有肝病史差异有统计学意义（x^2=21．273，P〈0．001）；多因素非条件Logistic回归分析显示治疗前血清转氨酶升高（OR=2．978，95％CI：1．168-7．593）和既往有肝炎病史（OR=21．852，95％CI：5．410～88．196）与ATLI的发生呈正相关。结论与发生ATLI有关的危险因素是治疗前血清转氨酶升高和既往有肝炎病史。提示肺结核化疗强化期间，应加强检测肝功能，密切观察具有可能危险因素的患者，用药前可采取适当措施以提高治愈率。Objective To investigate the incidence of liver injury in Uygur patients with pulmonary tuberculosis during anti-tuberculosis chemotherapy and explore the causes of possible risk factors of liver injury, for a basis for treatment and control of tuberculosis. Methods A nested case-control study of 1 135 cases of Uygur patients were followed up and data were collected. Potential factors of ATLI were analyzed. Results Incidence of ATLI was 3.08%. The single test showed a history of liver disease was statistically significant （ x^2 = 21. 273, P 〈 0. 001 ）. The results of multivariate Logistic regression analysis indicated that ATLI was associated with a elevated serum transaminases before treatment （ OR = 2. 978, 95% CI：1. 168-7.593） and previous history of hepatitis （OR =21.852,95% CI：5.410-88. 196）. Conclusions The treatment of TB patients have a elevated serum transaminases before treatment and previous history of hepatitis may be the risk factor of ATLI. In the tuberculosis patients receiving anti-TB drugs, the monitoring of liver function should be stren- thened. Patients with possible risk factors should be observed closely so that appropriate measures can be taken to improve the treatment effect.

关 键 词：抗结核药 肝 危险因素 

分 类 号：R521[医药卫生—内科学] R181.1[医药卫生—临床医学]