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抗结核治疗引起的肝毒性:预测因素的作用

Antituberculosis treatment-induced hepatotoxicity: role of predictive factors.

作者信息

Singh J, Arora A, Garg P K, Thakur V S, Pande J N, Tandon R K

机构信息

Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi.

出版信息

Postgrad Med J. 1995 Jun;71(836):359-62. doi: 10.1136/pgmj.71.836.359.

Abstract

Antituberculosis drug-induced hepatotoxicity is quite common. However, factors predicting its development are still controversial. The objective of the present study was to evaluate the role of certain factors (age and sex of the patient, alcoholism, chronic liver disease, hepatitis B virus carrier status, acetylator status, nutritional status and antituberculosis treatment (ATT) regimen) in predicting the development of ATT-induced hepatitis. In a case-control study, 60 consecutive patients with evidence of ATT-induced hepatitis were studied to assess the possible association of the above-mentioned factors with ATT-induced hepatitis. Body mass index was found to be significantly lower in ATT-induced hepatitis patients (17.2 +/- 2.7) than in controls (19.5 +/- 3.3) (p < 0.05). Pyrazinamide was used in addition to isoniazid and rifampicin in a significantly higher percentage of patients in the ATT-induced hepatitis group (70%) as compared with those in the control group (42%). No significant differences were observed between the two groups with regard to the rest of the parameters.

摘要

抗结核药物引起的肝毒性相当常见。然而,预测其发生的因素仍存在争议。本研究的目的是评估某些因素(患者的年龄和性别、酗酒、慢性肝病、乙型肝炎病毒携带者状态、乙酰化状态、营养状况和抗结核治疗(ATT)方案)在预测ATT引起的肝炎发生中的作用。在一项病例对照研究中,对60例连续出现ATT引起肝炎证据的患者进行研究,以评估上述因素与ATT引起肝炎的可能关联。发现ATT引起肝炎的患者体重指数(17.2±2.7)显著低于对照组(19.5±3.3)(p<0.05)。与对照组(42%)相比,ATT引起肝炎组中使用吡嗪酰胺联合异烟肼和利福平的患者比例显著更高(70%)。两组在其余参数方面未观察到显著差异。

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本文引用的文献

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Hepatotoxicity of antituberculous drugs.抗结核药物的肝毒性
J Assoc Physicians India. 1982 May;30(5):295-8.
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Hepatotoxicity of isoniazid and rifampin in children.
Indian Pediatr. 1984 Feb;21(2):119-26.
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Effect of rifampicin and isoniazid on liver function.利福平与异烟肼对肝功能的影响。
Br Med J. 1972 Jan 15;1(5793):148-50. doi: 10.1136/bmj.1.5793.148.

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