抗结核药物性肝损害研究进展  

Progress in Research on Hepatic Injury Caused by Anti-Tuberculosis Drugs

作　　者：马勇滔 张祯祯[1] 

机构地区：[1]重庆医科大学附属儿童医院感染科,重庆

出　　处：《临床医学进展》2024年第5期581-588,共8页Advances in Clinical Medicine

摘　　要：结核病是⼀种由结核分枝杆菌引起的慢性传染病,目前的结核病治疗主要是采用以一线抗结核治疗药物即异烟肼(Isoniazid, INH [H])、利福平(Rifampin, RIF [R])、吡嗪酰胺(Pyrazinamide, PZA [Z])、乙胺丁醇(Ethambutol, EMB [E])等联合应用为主的方案。异烟肼、利福平、吡嗪酰胺均具有肝脏毒性,联合长时间应用更加大了肝毒性。抗结核药物诱导的肝损伤(drug induced liver injury, DILI)是最重要的不良反应之一,不仅会影响抗结核治疗的方案和进程,还会因为计划外的更改药物或停药,因此导致治疗效果降低和不依从性。本文综述了一线抗结核药物的发生机制、治疗措施等,以加深对抗结核药物性肝损害的认识。Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis. Currently, the main treatment for tuberculosis is the combination of first-line anti-tuberculosis drugs, namely isoniazid, rifampin, pyrazinamideand ethambutol. Isoniazid, rifampin, and pyrazinamide all have hepatotoxicity, and their combined long-term use exacerbates liver toxicity. Drug-induced liver injury (DILI) induced by anti-tuberculosis drugs is one of the most important adverse reactions, which not only affects the treatment regimen and progress of tuberculosis but also leads to decreased treatment effectiveness and non-compliance due to unplanned changes in medication or discontinuation. This article reviews the mechanism of action and treatment measures of first-line anti-tuberculosis drugs to deepen understanding of hepatic injury caused by anti-tuberculosis drugs.

关 键 词：抗结核药物 药物性肝损害 

分 类 号：R52[医药卫生—内科学]