200例初治菌阳肺结核患者一线抗结核药物治疗后不良反应分析  

Analysis of adverse reactions of 200 new bacteriological positive pulmonary tuberculosis patients treated with first-line antituberculosis drugs

作　　者：刘国标[1] 谭守勇[2] 林晓珊[1] 龚芳[1] 杨琼[1] 

机构地区：[1]广州市胸科医院第一门诊部广州市结核病防治所第一分所,510095 [2]广州市胸科医院第一门诊部肺研所,510095

出　　处：《结核病与肺部健康杂志》2015年第4期228-232,共5页Journal of Tuberculosis and Lung Health

摘　　要：目的 了解初治菌阳肺结核患者一线抗结核药物治疗后不良反应的发生情况.方法 于2012年9月至2013年4月,选取广州市越秀区结核病防治所确诊并开始治疗的初治菌阳肺结核患者作为研究对象,共200例.对其在抗结核治疗中出现的不良反应进行分析,并根据是否出现药物不良反应分为不良反应组和无不良反应组,以及根据是否出现肝功异常分为肝功能异常组和肝功能正常组,分别对两组间各评价指标的差异进行分析.结果 200例患者中,发生不良反应者127例,发生率为63.5％,其中出现肝功能异常者50例,发生率25.0％.不良反应出现在治疗开始后前2个月的有111例.肝功能异常组乙型肝炎病毒表面抗原阳性率为18.0％（9/50）,肝功能正常组为8.0％（12/150）,差异有统计学意义（x^2=3.99,P=0.046）.所有患者中治愈173例,占86.5％.结论 抗结核药品不良反应发生率较高,但抗结核药物不良反应的发生对治疗方案、治疗效果影响较少.Objective To understand the adverse reactions caused by first-line antituberculosis （anti-TB） drugs in new bacteriological positive pulmonary tuberculosis （PTB） patients. Methods Adverse reactions of 200 cases of new bacteriological positive PTB patients diagnosed and treated in Yuexiu TB Control Institute from September 2012 to April 2013 were analyzed. The cases were divided into adverse reactions group and no adverse reactions group, abnormal liver function group and normal liver function group. The differences between the two groups were analyzed. Results There were 1Z7 cases with adverse reaction, and the incidence rate was 63.5% （127/200）, abnormal liver function appeared in 50 cases, and the incidence rate was 25% （50/200）. There were Ill cases with the adverse reaction appeared in 2 months of the treatment. Positive rate of hepatitis B surface anti- gen in abnormal liver function group was 18.0^ （9/50）, and that in normal liver function group was 8.0^ （12/150）, and the difference was statistically significant （x^2 =3.99, P=0. 046）. 173 cases were cured, and the cure rate was 86.5^ （173/200）. Conclusion The incidence rate of adverse reaction caused by anti-TB drugs is higher, while the impact on treatment regimen and treatment effect is small.

关 键 词：结核 肺 药物性肝损伤 药物过敏 

分 类 号：R521[医药卫生—内科学]