甘草酸二铵肠溶胶囊预防老年初治涂阳肺结核强化期药物性肝损伤的临床观察  

Clinical observation of diammonium glycyrrhizinate enteric-coated capsules in preventing drug-induced liver injury in elderly patients with initial smear positive pulmonary tuberculosis in intensive stage

作　　者：李敏[1] 胡启江[1] 汪亮[1] LI Min;HU Qijiang;WANGLiang(Department of Infectious Diseases,Jianghan University Affiliated Hospital Huangpi People's Hospital,Hubei Province,Wuhan 430300,China)

机构地区：[1]江汉大学附属黄陂区人民医院感染科,武汉市430300

出　　处：《临床合理用药杂志》2020年第7期25-26,28,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察甘草酸二铵肠溶胶囊预防老年初治涂阳肺结核强化期药物性肝损伤的临床效果。方法选取2014年1月-2018年1月江汉大学附属黄陂区人民医院感染科诊治的老年人继发性肺结核初治涂阳患者136例,按照随机数字表法分为治疗组和对照组各68例,2组强化期均采用2HRZE抗结核方案,同时治疗组给予甘草酸二铵肠溶胶囊预防肝损伤,对照组给予还原型谷胱甘肽片预防肝损伤。比较2组肝脏功能、电解质及不良反应发生情况。结果治疗组肝功能异常发生率为19.12%低于对照组的54.41%(χ~2=18.218,P<0.05)。治疗组更换抗结核治疗方案5例(7.35%),对照组调整或停止抗结核治疗29例(42.65%),2组比较差异有统计学意义(χ~2=22.588,P<0.05)。治疗组出现下肢轻度水肿2例,轻度低钾2例,均经对症治疗后消失,未影响治疗。结论甘草酸二铵肠溶胶囊能有效预防老年涂阳肺结核患者药物性肝损伤的发生。Objective To observe the clinical effect of diammonium glycyrrhizinate enteric-coated capsules in preventing drug-induced liver injury in elderly patients with initial smear positive pulmonary tuberculosis in intensive stage.Methods From January 2014 to January 2018,136 elderly patients with primary tuberculosis with secondary tuberculosis diagnosed and treated from the Department of Infectious Diseases Jianghan University Affiliated Hospital Huangpi People’s Hospital were selected.68 patients were divided into treatment group and control group according to random number table method.The antituberculosis regimens of both groups were 2 HRZE.The treatment group was given diammonium glycyrrhizinate enteric-coated capsules,while the control group was given glutathione tlablets to prevent liver injury.The liver function,electrolytes,and adverse reactions were compared between the two groups.Results The incidence of liver dysfunction in the treatment group was 19.12%lower than 54.41%in the control group(χ~2=18.218,P<0.05).In the treatment group,5 patients(7.35%)changed the antituberculosis treatment regimen,and in the control group,29 patients(42.65%)adjusted or stopped antituberculosis treatment,the difference between the two groups was statistically significant(χ~2=22.588,P<0.05).In the treatment group,there were 2 cases of mild lower limb edema and 2 cases of mild hypokalemia,all of them disappeared after symptomatic treatment without affecting treatment.Conclusion Diammonium glycyrrhizinate enteric-coated capsules can effectively prevent the occurrence of drug-induced liver injury in elderly patients with pulmonary tuberculosis.

关 键 词：甘草酸二铵肠溶胶囊 药物性肝损伤 老年肺结核 

分 类 号：R521[医药卫生—内科学]