[摘要] 目的 動態監測肺結核患者的抗結核藥物引起肝功能損害及其他不良反應發生率及其影響因素。方法 用前瞻性研究方法係統地觀察我院2年內診治的所有初治塗陽肺結核患者抗結核藥物引起肝功能損害及其他不良反應發生率及其影響因素。結果 84例肝功能損害及265例其他不良反應；肝功能輕度異常52例(4.96%)，中度異常26例(2.48%)，重度異常6例(0.57%)。265例不良反應中，發熱96例(9.16%)，有胃腸道症狀、惡心、嘔吐61例(5.82%)，血尿酸增高32例(3.05%)，頭暈19例(1.81%)、皮疹12例(1.14%)，其他24例(2.29%)。結論 抗結核藥易引起藥物性肝炎，用藥期間應注意肝功能檢測及其他不良反應，對存在高危因素的患者應注意用藥。
[關鍵詞] 肝炎； 藥物性； 抗結核藥； 不良反應
[中圖分類號] R978.3；R575 [文獻標識碼] A [文章編號] 1673-9701(2010)03-45-02
Dynamic Monitoring of Anti-TB Drug-induced Liver Function Damage and Other Adverse Reactions
MEI Yuezhi YANG Liming
Dongguan Municipal Hospital of Chronic Diseases，Dongguan 523008，China
[Abstract] ObjectiveTo dynamically monitor the incidence and influencing factors of anti-TB drug-induced liver function damage and other adverse reactions in TB patients. MethodsA prospective analysis was made to systematically observe the incidence and influencing factors of anti-TB drug-induced liver function damage and other adverse reactions of all newly smear-positive TB patients treated in the past two years at our hospital. ResultsEighty-four cases showed damages to liver functions including 52 cases(4.96%) of mildly abnormal liver function，26 cases(2.48%)of moderate abnormality，6 cases(0.57%)of severe abnormality ，and 265 cases of other adverse reactions including 96 cases of fever(9.16%)，61 cases(5.82%)of gastrointestinal symptoms，nausea and emesis，32 cases(3.05%)of increased blood uric acid，19(1.81%)cases of dizziness，12 cases(1.14%)of skin rash and 24 other cases(2.29%). ConclusionAnti-TB drugs easily cause drug-induced hepatitis. It is important to examine liver functions and other adverse reactions during the period of medication. Individualized medication is necessary for the patients with high-risk factors.
[Key words]Hepatitis； Drug induced； Anti-TB drugs； Adverse reactions
藥物性肝損害(druginduced liver injury)是指用藥過程中肝髒因受藥物的直接或間接作用而發生的功能和結構的損害，文獻報道抗結核藥物引起的不良反應發生率平均為12.6%[1]。現將我院2006~2008年收治的抗結核過程中所出現的肝功能損害84例及265例其他不良反應進行分析，報道如下。