Time of Liver Function Abnormal Identification on Prediction of the Risk of Anti-tuberculosis-induced Liver Injury  

作　　者：Deliang Huang Jinghan Peng Lin Lei Yuanyuan Chen Zhibing Zhu Qingxian Cai Yongcong Deng Jun Chen 

机构地区：[1]Department of Liver Diseases,The Third People’s Hospital of Shenzhen,The Second Affiliated Hospital of Southern University of Science and Technology,Shenzhen,Guangdong,China [2]Department of Tuberculosis,The Third People’s Hospital of Shenzhen,The Second Affiliated Hospital of Southern University of Science and Technology,Shenzhen,Guangdong,China

出　　处：《Journal of Clinical and Translational Hepatology》2023年第2期425-432,共8页临床与转化肝病杂志（英文版）

基　　金：supported by the funds for the construction of key medical disciplines in Shenzhen.

摘　　要：Background and Aims:Anti-tuberculosis(anti-TB)druginduced liver injury(AT-DILI)is the most common side effect in patients who received anti-TB therapy.AT-DILI management includes monitoring liver function until symptoms arise in patients without high-risk factors for liver damage.The present study aimed to investigate the effect of liver function test(LFT)abnormal identification on the risk of DILI,including liver failure and anti-TB drug resistance in patients without high-risk factors.Methods:A total of 399 patients without high-risk factors for liver damage at baseline and who experienced LFT abnormal during the 6 months of first-line anti-TB treatment were enrolled.The Roussel Uclaf Causal Relationship Assessment Method(RUCAM,2016)was applied in suspected DILI.The correlations between the time of LFT abnormal identification and DILI,liver failure,and anti-TB drug resistance were analyzed by smooth curve fitting and multivariable logistic regression models.Results:Among all study patients,131 met the criteria for DILI with a mean RUCAM causality score of 8.86±0.63.26/131 and 105/131 were in the probable grading and highly probable grading,respectively.The time of abnormal LFT identification was an independent predictor of DILI,liver failure,and anti-TB drug resistance in the crude model and after adjusting for other risk patient factors.The time of abnormal LFT identification was positively correlated with DILI,liver failure,and anti-TB drug resistance.The late identification group(>8 weeks)had the highest risk of DILI,followed by liver failure compared with the other two groups.Conclusions:The time to identification of LFT was positively correlated with DILI,liver failure,and anti-TB drug resistance.The risk of DILI and liver failure was significantly increased in the late identification group with abnormal LFT identified after 8 weeks compared with 4 and 8 weeks.Early monitoring of LFT is recommended for patients without the high-risk factor of DILI after anti-TB treatment is initiated.

关 键 词：Liver function abnormal identification time Anti-tuberculosis induced liver injury Liver failure RUCAM causality scale 

分 类 号：R575[医药卫生—消化系统]