单纯肺结核与肺结核并HIV感染患者的抗结核药物性肝损伤临床特征分析  

Clinical characteristics of anti-tuberculosis drug-induced liver injury in patients with simple pulmonary tuberculosis and pulmonary tuberculosis combine with HIV infection

作　　者：陆霓虹 刘洪璐 孙娅萍 陈杨君 杨艳 杜映荣 LU Nihong;LIU Honglu;SUN Yaping;CHEN Yangjun;YANG Yan;DU Yingrong(Yunnan Provincial Clinical Medical Center for Infectious Diseases,Kunming Third People’s Hospital,Yunnan Province,Kunming650041,China)

机构地区：[1]昆明市第三人民医院云南省传染性疾病临床医学中心,云南昆明650041

出　　处：《中国医药导报》2023年第1期90-93,共4页China Medical Herald

基　　金：国家自然科学基金地区科学基金项目(81960096);云南省科技厅科技计划项目地方高校联合专项项目(202001BA070001-134);云南省昆明市科技计划项目重点项目(昆科计字2019-1-N-25318000003253)。

摘　　要：目的 分析单纯肺结核与肺结核并人类免疫缺陷病毒(HIV)感染患者抗结核药物性肝损伤(ATB-DILI)的临床特征。方法 回顾性分析2019年1月至2021年1月昆明市第三人民医院收治的128例ATB-DILI肺结核患者的临床资料,其中单纯性肺结核患者76例为A组,肺结核并HIV感染患者52例为B组。收集两组一般资料及临床资料;分析两组ATB-DILI严重程度;记录两组ATB-DILI发生时间。结果 B组球蛋白低于A组(P<0.05);两组天冬氨酸转氨酶、丙氨酸转氨酶、γ-谷氨酰转肽酶、乳酸脱氢酶、碱性磷酸酶、总蛋白、白蛋白、总胆红素、直接胆红素、间接胆红素、总胆汁酸比较,差异无统计学意义(P>0.05)。两组ATB-DILI程度分级比较,差异有统计学意义(P<0.05)。两组发生ATB-DILI时间比较,差异有统计学意义(P<0.05)。结论 低蛋白状态是影响肺结核并HIV感染患者发生ATB-DILI的因素之一,肺结核并HIV感染患者更早出现ATB-DILI。调整营养状态、及早应用保肝药物,可能对预防ATB-DILI有一定临床价值。Objective To analyze the clinical characteristics of anti-tuberculosis drug-induced liver injury(ATB-DILI) in patients with simple pulmonary tuberculosis and pulmonary tuberculosis combine with human immunodeficiency virus(HIV)infection.Methods Clinical data of 128 patients with ATB-DILI pulmonary tuberculosis admitted to Kunming Third People’s Hospital from January 2019 to January 2021 were retrospectively analyzed.Among them,76 patients with simple pulmonary tuberculosis were classified as group A,and 52 patients with pulmonary tuberculosis combine with HIV infection were classified as group B.General data and clinical data of two groups were collected;the severity of ATB-DILI in two groups was analyzed;the occurrence time of ATB-DILI in two groups was recorded.Results Globulin in group B was lower than that in group A(P0.05).The difference of ATB-DILI degree between two groups was statistically significant(P<0.05).There was statistical significance in the occurrence time of ATB-DILI between two group(P<0.05).Conclusion Low protein status is one of the factors for ATB-DILI in patients with pulmonary tuberculosis combine with HIV infection,and ATB-DILI appears earlier in patients with pulmonary tuberculosis combine with HIV infection.Adjusting nutritional status and early application of hepatoprotective drugs may have certain clinical value in preventing ATB-DILI.

关 键 词：单纯肺结核 肺结核并HIV感染 抗结核药物性肝损伤 临床特征 

分 类 号：R978.3[医药卫生—药品]