预防性应用保肝药物在抗结核治疗中的临床意义  

Clinical Significance of Prophylactic Application of Hepatoprotective Drugs in Antituberculosis Treatment

作　　者：李萌 郑朝文 毛传春 LI Meng;ZHENG Chaowen;MAO Chuanchun(Department of Tuberculosis I,Xuzhou Hospital of Infectious Diseases,Xuzhou,Jiangsu Province,221004 China;Department of Emergency Surgery,Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu Province,221000 China)

机构地区：[1]徐州市传染病医院结核一科,江苏徐州221004 [2]徐州医科大学附属医院急诊外科,江苏徐州221000

出　　处：《系统医学》2024年第3期102-104,108,共4页Systems Medicine

摘　　要：目的分析结核患者预防性应用保肝药物治疗的临床意义。方法选取2020年3月—2021年3月徐州市传染病医院收治的120例初治肺结核患者作为研究对象进行前瞻性研究。按照随机数表法分成观察组(n=60)和对照组(n=60),观察组患者在规范性应用抗结核药物治疗基础上,预防性应用水飞蓟宾葡甲胺片保肝药物,对照组仅规范性应用抗结核药物治疗。比较两组患者的肝损伤发生情况及肝功能(包括谷氨酸氨基转移酶、天冬氨酸氨基转移酶、谷氨酰转肽酶、碱性磷酸酶、总胆红素)指标。结果观察组的肝损伤发生率为6.67%,显著低于对照组的18.33%,差异有统计学意义(χ^(2)=5.087,P=0.024)。治疗后,观察组的血清丙氨酸氨基转移酶、天冬氨酸氨基转移酶、谷氨酰转肽酶、碱性磷酸酶、总胆红素水平均低于对照组,差异有统计学意义(P均<0.05)。结论初治结核患者预防性应用保肝药物治疗,可以有效减少抗结核药物性肝损伤的发生率和肝损伤程度。Objective To analyze the clinical significance of prophylactic application of hepatoprotective drug therapy in tuberculosis patients.Methods A prospective study was conducted on 120 newly treated tuberculosis pa⁃tients admitted to Xuzhou Infectious Disease Hospital from March 2020 to March 2021.The patients were divided into the observation group(n=60)and the control group(n=60)according to random number table method.On the ba⁃sis of normative anti-tuberculosis drug treatment,the patients in the observation group received preventive treatment of silybin meglumine tablets as hepatoprotective drugs,while the control group received normative anti-tuberculosis drug treatment only.The incidence of liver injury and liver function indexes(including glutamate aminotransferase,aspartate aminotransferase,glutamyl transpeptidase,alkaline phosphatase,total bilirubin)were compared between the two groups of patients.Results The incidence of liver injury in the observation group was 6.67%,significantly lower than that in the control group(18.33%),and the difference was statistically significant(χ^(2)=5.087,P=0.024).After treatment,the serum levels of alanine aminotransferase,aspartate aminotransferase,glutamyl transpeptidase,alkaline phosphatase and total bilirubin in observation group were lower than those in control group,and the differences were statistically significant(all P<0.05).Conclusion The prophylactic application of hepatoprotective drug therapy in first-treatment tuberculosis patients can effectively reduce the incidence of antituberculosis drug-induced liver injury and the degree of liver injury.

关 键 词：保肝治疗 抗结核 肝损伤 

分 类 号：R4[医药卫生—临床医学]