抗结核药物不良反应情况及影响因素分析  

Analysis of adverse reactions and influencing factors of anti-tuberculosis drugs

作　　者：邵根霞 甄利波 金露青 胡雪 魏强[1] 沈莉莉[1] SHAO Genxia;ZHEN Libo;JIN Luqing;HU Xue;WEI Qiang;SHEN Lili(Department of Tuberculosis,Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine,Hangzhou Red Cross Hospital,Hangzhou,310003,China)

机构地区：[1]浙江省中西医结合医院杭州市红十字会医院结核内科,浙江杭州310003

出　　处：《中国现代医生》2020年第24期120-123,共4页China Modern Doctor

基　　金：浙江省中医药科技计划项目(2017ZKL015)。

摘　　要：目的探讨抗结核药物不良反应情况及影响因素。方法选择2017年12月~2019年12月在医院诊断治疗的初治结核病患者为研究对象,根据是否发生抗结核药物不良反应分为不良反应组与无不良反应组,统计学分析影响抗结核药物不良反应相关因素。结果(1)264例患者中,125例发生抗结核药物不良反应,占47.35%。关联性评价为肯定的6例,判定为很可能的31例,判定为可能的88例。(2)单因素分析结果显示:饮酒、HBsAg阳性、ALT>正常上限≤2×正常上限、ALT>2×正常上限、AST>2×正常上限、BUN>正常上限的患者不良反应组发生率更高,差异有统计学意义(P<0.05)。(3)多因素分析结果显示:HBsAg阳性、ALT>正常上限≤2×正常上限、ALT>2×正常上限、AST>2×正常上限、BUN>正常上限是抗结核药不良反应的独立危险因素(P<0.05)。并且ALT水平越高,患者不良反应风险越大(OR=4.225)。结论抗结核药物不良反应发生率较高,患者肝功能指标异常、肾功能指标异常、HBsAg阳性是抗结核药物不良反应的独立危险因素,在临床工作中要重视乙肝、肝功能异常、肾功能异常的患者,尽量选择相对安全的药物,同时应注意定期复查肝肾功能。Objective To explore the adverse reactions and influencing factors of anti-tuberculosis drugs.Methods The newly diagnosed and treated tuberculosis patients in the hospital from December 2017 to December 2019 were selected as the research object,and they were divided into the adverse reaction group and the non-adverse reaction group according to whether the adverse reaction of anti-tuberculosis drugs occurred.Factors related to adverse reactions.The factors related to adverse reactions of anti-tuberculosis drugs were statistically analyzed.Results(1)125 out of 264 patients developed adverse reactions of anti-tuberculosis drugs,accounting for 47.35%.There were 6 cases where the relevance evaluation was affirmative,31 cases were judged as very likely,and 88 cases were judged as possible.(2)The results of univariate analysis showed that the incidence of adverse reactions in patients with alcohol consumption,HBsAg positive,ALT>upper limit of normal value≤2×upper limit of normal value,ALT>2×upper limit of normal value,AST>2×upper limit of normal value,BUN>upper limit of normal value was higher,and the difference was statistically significant(P<0.05).(3)The results of multivariate analysis showed that HBsAg positive,ALT>upper limit of normal value≤2×upper limit of normal value,ALT>2×upper limit of normal value,AST>2×upper limit of normal value,BUN>upper limit of normal value were independent risk factors for adverse reactions of anti-tuberculosis drugs(P<0.05).And the higher the ALT level,the greater the risk of adverse reactions(OR=4.225).Conclusion The incidence of adverse reactions of anti-tuberculosis drugs is high.Abnormal liver function indexes,abnormal renal function indexes,and positive HBsAg are independent risk factors for adverse reaction of anti-tuberculosis drugs.In clinical work,we should pay attention to hepatitis B,liver function abnormalities,and kidney function abnormalities patients,try to choose relatively safe drugs,and should pay attention to regular review of liver and kidney function.

关 键 词：抗结核药物 不良反应 肝功能 肾功能 

分 类 号：R521[医药卫生—内科学]