硫普罗宁在抗结核护肝治疗时对肾功能的影响  

Effect of tiopronin on renal function during antituberculosis therapy

作　　者：刘丽秀 李国锋 钟洪兰[2,3] 黄华英[2,3] 温秀珍 李祥[2,3] LIU Lixiu;LI Guofeng;ZHONG Hong-lan;HUANG Huaying;WEN Xiuzhen;LI Xiang(School of Pharmacy,Southern Medical University,Guangzhou 510515,Guangdong,China;Department of Pharmacy,Guangzhou Chest Hospital,Guangzhou 510095,Guang-dong,China;National Key Laboratory of Respiratory Diseases,Guangzhou Key Laboratory of Tuberculosis Research,Institute of Tuberculosis Control,Guangzhou Medical University,Guangzhou 510095,Guangdong,China;Department of Pharmacy,Nanfang Hospital,Southern Medical University,Guangzhou 510515,Guangdong,China)

机构地区：[1]南方医科大学药学院,广东广州510515 [2]广州市胸科医院药剂科,广东广州510095 [3]呼吸疾病全国重点实验室,广州市结核病研究重点实验室,广州医科大学结核病防治研究院,广东广州510095 [4]南方医科大学南方医院药学部,广东广州510515

出　　处：《实用医学杂志》2024年第23期3362-3366,共5页The Journal of Practical Medicine

基　　金：广州市科技计划项目(编号:2024A03J0513)。

摘　　要：目的探究硫普罗宁在抗结核护肝治疗时对肾功能的影响。方法回顾性分析2019年9月至2022年9月广州市胸科医院收治初治敏感结核且抗结核方案仅为异烟肼、利福平、吡嗪酰胺和乙胺丁醇的患者临床资料。根据是否使用硫普罗宁分成研究组和对照组,比较两组患者的基线资料、血肌酐(Scr)、血尿素氮(BUN)、尿蛋白、肌酐清除率、合并用药及相关不良反应变化情况。结果根据纳入排除标准获得的患者分为研究组(n=102)(抗结核药+硫普罗宁)和对照组(n=105)(抗结核药+谷胱甘肽)。两组患者治疗前、治疗中、治疗后的ALT、AST、DBIL、TBIL水平差异均无统计学意义(P>0.05)。在治疗后期,研究组与对照组血清Scr、BUN、肌酐清除率和尿蛋白差异均有统计学意义(P<0.05)。治疗后期研究组指标异常率和不良反应发生率高于对照组(P<0.05)。结论对于结核治疗的患者,使用硫普罗宁和谷胱甘肽进行保肝治疗的疗效相当,但是长期用药硫普罗宁的肾功能损伤较为明显一些。Objective To investigate the effect of tiopronin on renal function during anti⁃tuberculosis liver protection therapy.Methods Clinical data of patients with initially treated sensitive tuberculosis treated in our hos⁃pital from September 2019 to September 2022 and whose anti⁃tuberculosis regimen was only isoniazid,rifampicin,pyrazinamide and ethambutol were retrospectively analyzed.The patients were divided into study group and control group according to whether tiopronin was used.The baseline data,blood creatinine(Scr),blood urea nitrogen(BUN),urine protein,creatinine clearance,drug combination and related adverse reactions of the two groups were compared.Results Patients obtained based on inclusion and exclusion criteria were divided into a study group(n=102)(antitubercular drugs+tiopronin)and a control group(n=105)(antitubercular drugs+glutathione).There were no statistically significant differences(P>0.05)in ALT,AST,DBIL,and TBIL levels between the two groups before treatment,at Middle and late treatment.At the later stage of treatment,serum Scr,BUN,creatinine clearance and urinary protein showed statistical differences between the study group and the control group(P<0.05).The abnormal rate of indicators and the incidence of adverse reactions in the study group were higher than those in the control group at the later stage of treatment(P<0.05).Conclusion For patients undergoing tuberculosis treatment,the efficacy of tiopronin and glutathione in protecting the liver is comparable.However,in terms of renal function,long⁃term use of tiopronin is associated with more pronounced damage.Due to the relatively low cost of tiopronin,for families with heavy economic burdens,short⁃term use of the drug can ensure safety,while long⁃term use requires close monitoring of renal function changes and timely adjustments to medication.

关 键 词：硫普罗宁 结核 肾功能 安全性 

分 类 号：R9[医药卫生—药学]