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埃塞俄比亚部分医院结核病患者中抗结核药物所致肝毒性及相关因素

Anti-Tuberculosis Drug Induced Hepatotoxicity and Associated Factors among Tuberculosis Patients at Selected Hospitals, Ethiopia.

作者信息

Molla Yalew, Wubetu Muluken, Dessie Bekalu

机构信息

Pharmacy Department, Health Science College, Debre Markos University, Debre Markos, Ethiopia.

出版信息

Hepat Med. 2021 Jan 28;13:1-8. doi: 10.2147/HMER.S290542. eCollection 2021.

Abstract

BACKGROUND

Tuberculosis caused by susceptible mycobacterium tuberculosis strains is effectively treated by the first-line anti-tuberculosis drugs. However, most antibacterial drugs are known to induce hepatotoxicity which may limit their adherence and hence lead to the development of mycobacterial drug resistance.

OBJECTIVE

The aim of this study was to assess the incidence of anti-tuberculosis drug induced hepatotoxicity and associated factors among tuberculosis patients of Debre Markos, Mota, and Bichena Hospitals.

METHODS

The prospective cross sectional-study was conducted in three hospitals of East Gojjam zone by taking blood samples of new tuberculosis patients every 2 weeks for 2 months to measure the elevation of liver proteins indicating liver toxicity from the onset of starting therapy. A semi-structured questionnaire was also used to collect the socio-demographic data and factors of anti-tubeculosis drug induced liver toxicity. To identify factors associated with drug induced hepatotoxicity, binary logistic regression followed by multivariate analysis was applied at a statistically significant level of <0.05.

RESULTS

The incidence of hepatotoxicity among tuberculosis patients is 7.9%. Diagnosis of extrapulmonary tuberculosis, having comorbid disease, and old age are significantly associated (<0.05) with first-line antituberculosis drugs induced hepatotoxicity.

CONCLUSION

The incidence of hepatotoxicity is relatively high among tuberculosis patients taking first-line anti-tuberculosis drugs. Therefore, the liver function of patients with old age, comorbid diseases, and extrapulmonary tuberculosis should be regularly monitored to reduce the severity of drug-induced hepatotoxicity.

摘要

背景

由敏感结核分枝杆菌菌株引起的结核病可通过一线抗结核药物得到有效治疗。然而,大多数抗菌药物已知会诱发肝毒性,这可能会限制患者的依从性,进而导致分枝杆菌耐药性的产生。

目的

本研究旨在评估德布雷马科斯、莫塔和比切纳医院结核病患者中抗结核药物所致肝毒性的发生率及相关因素。

方法

在东戈贾姆地区的三家医院开展前瞻性横断面研究,对新确诊的结核病患者每2周采集一次血样,持续2个月,以测定开始治疗后指示肝毒性的肝蛋白升高情况。还使用半结构化问卷收集社会人口学数据及抗结核药物所致肝毒性的相关因素。为确定与药物性肝毒性相关的因素,采用二元逻辑回归,随后进行多变量分析,设定统计学显著性水平<0.05。

结果

结核病患者中肝毒性的发生率为7.9%。肺外结核诊断、合并疾病和老年与一线抗结核药物所致肝毒性显著相关(<0.05)。

结论

服用一线抗结核药物的结核病患者中肝毒性发生率相对较高。因此,应定期监测老年、合并疾病及肺外结核患者的肝功能,以减轻药物性肝毒性的严重程度。

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Hepatotoxicity Related to Anti-tuberculosis Drugs: Mechanisms and Management.抗结核药物相关肝毒性:机制与管理
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