Liu Yi-Hui, Guo Yan, Xu Hong, Feng Hui, Chen Dong-Ya
Department of Digestive Hepatology, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, 310003, People's Republic of China.
Department of Gastroenterology, Hangzhou Third Hospital, Hangzhou, Zhejiang, 310009, People's Republic of China.
Infect Drug Resist. 2021 Sep 9;14:3667-3671. doi: 10.2147/IDR.S326386. eCollection 2021.
To observe the effect of non-alcoholic simple fatty liver disease on drug-induced liver injury caused by tuberculosis.
We retrospectively analyzed the incidence, characteristics, and risk factors of antituberculosis drug-induced liver injury in 104 patients with initial treatment of tuberculosis complicated with non-alcoholic simple fatty liver disease. The patients were divided into two groups according to whether there was liver injury or not. The differences in age, gender, body mass index (BMI), cholesterol, and triglycerides were studied between the two groups.
Among the 104 patients with initial treatment of tuberculosis complicated with non-alcoholic fatty liver disease, 24 (23%) patients developed a drug-induced liver injury. The remaining 80 (77%) patients did not develop drug-induced liver injury ( = 60.308, P < 0.05). In the liver injury group, there were 20 cases of mild liver injury, two cases of moderate liver injury, two cases of severe liver injury, 22 cases of hepatocellular injury, two cases of cholestasis, and no cases of mixed liver injury. The time of abnormal liver function in antituberculosis treatment was 16.42 ± 9.18 days from the beginning of the antituberculosis treatment. There were no significant differences in gender, age, BMI, or triglyceride between the liver injury group and the non-liver injury group ( = 2.063, t = 0.179, t = 0.703, t = 1.12, P > 0.05 in all), but there were significant differences in cholesterol (t = 3.08, P < 0.05). By logistic regression analysis, cholesterol was a high-risk factor for liver injury.
Non-alcoholic simple fatty liver disease may increase the risk of antituberculosis drug-induced liver injury.
观察非酒精性单纯性脂肪肝对结核病药物性肝损伤的影响。
回顾性分析104例初治结核病合并非酒精性单纯性脂肪肝患者抗结核药物性肝损伤的发生率、特点及危险因素。根据是否发生肝损伤将患者分为两组。研究两组患者在年龄、性别、体重指数(BMI)、胆固醇和甘油三酯方面的差异。
104例初治结核病合并非酒精性脂肪肝患者中,24例(23%)发生药物性肝损伤。其余80例(77%)患者未发生药物性肝损伤(χ² = 60.308,P < 0.05)。肝损伤组中,轻度肝损伤20例,中度肝损伤2例,重度肝损伤2例,肝细胞损伤22例,胆汁淤积2例,无混合性肝损伤病例。抗结核治疗中肝功能异常时间距抗结核治疗开始为16.42±9.18天。肝损伤组与非肝损伤组在性别、年龄、BMI或甘油三酯方面无显著差异(χ² = 2.063,t = 0.179,t = 0.703,t = 1.12,P均> 0.05),但胆固醇有显著差异(t = 3.08,P < 0.05)。经logistic回归分析,胆固醇是肝损伤的高危因素。
非酒精性单纯性脂肪肝可能增加抗结核药物性肝损伤的风险。