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1149例住院结核病患者治疗初始阶段一线抗结核药物的副作用

Side effects due to primary antituberculosis drugs during the initial phase of therapy in 1149 hospitalized patients for tuberculosis.

作者信息

Gülbay Banu Eriş, Gürkan Ozlem Ural, Yildiz Oznur Akkoca, Onen Zeynep Pinar, Erkekol Ferda Oner, Baççioğlu Ayşe, Acican Turan

机构信息

Department of Chest Diseases, Ankara University Faculty of Medicine, Ankara, Turkey.

出版信息

Respir Med. 2006 Oct;100(10):1834-42. doi: 10.1016/j.rmed.2006.01.014. Epub 2006 Mar 6.

Abstract

OBJECTIVE

Side effects of the most commonly used primary antituberculosis (anti-TB) drugs may be mild as well as fatal. The aim of this study was to evaluate the side effects of and the risk factors for developing side effects against anti-TB drugs.

PATIENTS AND METHODS

Records of 1149 patients with established tuberculosis who initially received anti-TB therapy were evaluated retrospectively. The major side effects, which resulted in a definitive termination from 1 or more drugs related to anti-TB therapy, and the risk factors associated with these side effects, were analyzed.

RESULTS

Ninety-five patients (8.3%), constituting 104 cases in total, experienced side effects. Although the frequency of drug reactions were increased from 0.6% at ages <20 to 5.2% at ages 20-40, no gender or age differences were observed between patients who did and did not have side effects. While asymptomatic liver function disturbance was established in 56 of the patients (4.9%) with initiation of anti-TB therapy, the rate of hepatotoxicity was found to be 2.4% in this present study. No age or gender differences were observed among those who had hepatotoxicity and who had not. The major side effects were ototoxicity (1.7%), hepatotoxicity (0.8%), neuropsychiatric manifestations (0.7%), and hyperuricemia (0.6%).

CONCLUSIONS

It must be remembered that severe side effects associated with anti-TB drugs were encountered with different frequencies especially among patients hospitalized for pulmonary tuberculosis, and these patients should be followed up by closer monitoring for side effects related to anti-TB drugs.

摘要

目的

最常用的一线抗结核药物的副作用可能较轻,也可能致命。本研究的目的是评估抗结核药物的副作用以及出现副作用的风险因素。

患者与方法

回顾性评估1149例确诊为结核病且最初接受抗结核治疗的患者的记录。分析导致与抗结核治疗相关的1种或多种药物最终停用的主要副作用,以及与这些副作用相关的风险因素。

结果

95例患者(8.3%)共出现104例副作用。尽管药物反应发生率从<20岁患者的0.6%增至20 - 40岁患者的5.2%,但出现和未出现副作用的患者之间未观察到性别或年龄差异。在开始抗结核治疗的患者中,56例(4.9%)出现无症状肝功能紊乱,本研究中肝毒性发生率为2.4%。出现肝毒性和未出现肝毒性的患者之间未观察到年龄或性别差异。主要副作用为耳毒性(1.7%)、肝毒性(0.8%)、神经精神表现(0.7%)和高尿酸血症(0.6%)。

结论

必须牢记,与抗结核药物相关的严重副作用出现频率各异,尤其是在因肺结核住院的患者中,应对这些患者密切监测抗结核药物相关的副作用。

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