Frontera Izquierdo P, Unceta Aguirre L, Tomás Vila M, Calvo Rigual F, Pérez Tamarit D
An Esp Pediatr. 1981 Dec;15(6):549-52.
Thirty four children with tuberculous meningitis were treated with rifampicin (mean, 17 mg/kg/day) and isoniazid (mean, 18 mg/kg/day). Fifteen (44%) showed rise in transaminase GOT and GPT values and four cases (11.7%) developed jaundice, hepatomegaly and low prothrombin levels. Rifampicin was removed in only nine of these 15 cases with signs of liver disfunction, but complete normalization of liver function and disappearance of symptoms occurred in all cases even when the treatment was not interrupted. Children are more sensitive to hepatic injury during rifampicin and isoniazid combination therapy than adults. Our results indicate very good prognosis for this hepatopathy and suggest that rifampicin need not be withdrawn in the benign situations. Removal of the rifampicin treatment may delay recovery of serious cases of tuberculous meningitis.
34名结核性脑膜炎患儿接受了利福平（平均17毫克/千克/天）和异烟肼（平均18毫克/千克/天）治疗。15名（44%）患儿的谷草转氨酶（GOT）和谷丙转氨酶（GPT）值升高，4例（11.7%）出现黄疸、肝肿大和凝血酶原水平降低。在这15例有肝功能障碍体征的患儿中，仅9例停用了利福平，但即使不中断治疗，所有病例的肝功能均完全恢复正常且症状消失。儿童在利福平和异烟肼联合治疗期间比成人对肝损伤更敏感。我们的结果表明这种肝病预后非常好，并提示在良性情况下无需停用利福平。停用利福平治疗可能会延迟重症结核性脑膜炎病例的康复。
