抗结核药物对肺结核合并乙肝患者肝功能及HBV-DNA水平影响  

Effects of antituberculosis drugs on liver function and HBV-DNA level in tuberculosis patients combined with HBV infection

作　　者：邱惠萍[1] 卢伟力[2] 陈晓春[2] 卢滔[2] 林丽红[2] 

机构地区：[1]衢州职业技术学院医学院,浙江324000 [2]衢州市人民医院感染科

出　　处：《中国地方病防治》2016年第8期877-878,共2页Chinese Journal of Control of Endemic Diseases

基　　金：衢州市科技计划项目(2013129)

摘　　要：目的探讨抗结核药物对肺结核合并乙型肝炎病毒(HBV)感染者肝损害与HBV-DNA水平影响,及抗结核药物性肝损害与HBV感染的相关性。方法选110例合并乙肝的肺结核患者,依据血清HBV-DNA水平分为高水平组64例、低水平组46例,68例HBeAg阳性组与42例HBeAg阴性组,均给予抗结核治疗,比较患者肝损害发生率、损害程度,分析肝损害与血清HBV-DNA定量水平相关性。结果高水平组肝损害发生率高于低水平组(P<0.05),肝损害发生率与HBV-DNA水平有关;HBeAg阴性组血清HBV-DNA水平与ALT、AST、TBI呈显著正相关(P<0.05);高水平组肝功能损伤时间明显低于低水平组(P<0.05),肝功能恢复时间明显高于低水平组(P<0.05)。结论肺结核合并乙肝患者化疗期间需密切监测肝功能,应用保肝药物,HBV-DNA阳性者需抗病毒治疗。Objective To explore the effects of antituberculosis drugs on liver function and HBV-DNA level in tuberculosis pa- tients combined with HBV infection, and the correlation between antituberculosis drug-induced liver injury and HBV Infection. Methods A total of 110 tuberculosis patients combined with HBV infection were selected. The patients were divided into high-level group （ 64 cases ）, low-level group （46 cases ） basing on serum HBV-DNA quantification, including 68 HBeAg-posi- rive cases and 42 HBeAg-negative cases, who were given anti-TB treatment, the liver injury incidence, hepatic injury degree and correlation between liver damage HBV-DNA quantitative were analyzed. Results Liver injury incidence of high-level group was higher than that of low-level group （ P〈0.05 ） ; Liver injury was related to the level of HBV-DNA quantitative. HBV-DNA quantitation levels showed significant positive correlation to ALT, AST, and TBI level in HBeAg negative group （P〈0. 051 ; The hepatic injury time in HBV-DNA high-level group was significantly lower than that in the low group （P〈0. 05 ） ; liver function recovery time in HBV-DNA high-level group was significantly higher than the low group （ P〈0. 05 ）. Conclusion Liver function should be monitored during chemotherapy in patients with pulmonary tuberculosis combined with HBV infection and protec- tion drugs should be given. Antiviral therapy should be performed to HBV-DNA positive patients.

关 键 词：肺结核 HBV感染 肝功能 抗结核药物 

分 类 号：R521[医药卫生—内科学] R512.62[医药卫生—临床医学]