Incharge, Pediatric Tuberculosis Clinic, B.J. Wadia Hospital for Children, Parel, Mumbai, India.
Ann Hepatol. 2012 Jan-Feb;11(1):96-9.
To determine the incidence and factors associated with drug induced hepatic dysfunction in children on anti-tuberculous treatment (ATT).
Pediatric Tuberculosis Clinic at B.J. Wadia Children's Hospital, Mumbai.
46 children with tuberculosis on ATT between April 2007 and February 2008 were included. Serum glutamic pyruvic transaminase (SGPT) level was measured at the beginning, after 15 days of starting ATT, at the end intensive phase and then if the patient developed symptoms of hepatic dysfunction. A value 3 times the normal value of the testing laboratory was considered to be significant for liver dysfunction. Liver dysfunction was analysed for association with factors like age, sex, weight, malnutrition, type of tuberculosis and severity of tuberculosis using SPSS Statistics software, Version 15.0.
Seven (15.2 %) out of 46 children developed drug induced hepatic dysfunction, of which 2 (28.6%) patients had 2 episodes of liver dysfunction while 5 (71.4%) had 1 episode of liver dysfunction. One (14.3%) developed symptom of hepatitis in the form of jaundice and hepatomegaly. All the patients developing liver dysfunction were in the intensive phase of treatment. The mean age of the children developing liver dysfunction was 4.0 ± 3.76 years. Liver dysfunction was associated with age younger than 3½ years (p = 0.025). Liver dysfunction was not associated with sex, weight, malnutrition, type of tuberculosis and severity of tuberculosis.
Regular monitoring of SGPT levels is recommended in all children on ATT below the age of 3 ½ years.
确定抗结核治疗（ATT）儿童中药物性肝损伤的发生率和相关因素。
孟买 B.J. Wadia 儿童医院儿科结核病诊所。
纳入 2007 年 4 月至 2008 年 2 月期间接受 ATT 的 46 例结核病儿童。在开始 ATT 后第 15 天、强化期结束时以及患者出现肝损伤症状时测量血清谷氨酸丙酮酸转氨酶（SGPT）水平。检测实验室正常值的 3 倍被认为是肝功能异常的显著值。使用 SPSS Statistics 软件，版本 15.0 分析肝功能异常与年龄、性别、体重、营养不良、结核病类型和结核病严重程度等因素的相关性。
46 例儿童中有 7 例（15.2%）发生药物性肝损伤，其中 2 例（28.6%）患者发生 2 次肝损伤，5 例（71.4%）发生 1 次肝损伤。1 例（14.3%）出现以黄疸和肝肿大为表现的肝炎症状。所有发生肝损伤的患者均处于强化治疗期。发生肝损伤的儿童平均年龄为 4.0±3.76 岁。肝损伤与年龄小于 3 岁半有关（p=0.025）。肝损伤与性别、体重、营养不良、结核病类型和严重程度无关。
建议所有年龄小于 3 岁半的 ATT 儿童定期监测 SGPT 水平。
