de Souza A F, de Oliveira e Silva A, Baldi J, de Souza T N, Rizzo P M
Faculdade de Medicina da Universidade Federal de Juiz de Fora, MG.
Arq Gastroenterol. 1996 Oct-Dec;33(4):194-200.
Antituberculosis therapy commonly used for pulmonary tuberculosis in Brazil include isoniazid (440 mg), rifampicin (600 mg) both for six months plus pyrazinamide (2 g) together in the first two months. Such therapy may induce acute or chronic liver damage in some individuals. The purpose of this study is to evaluate 1096 patients treated with antituberculous drugs, being 773 males and 323 females. Clinical and laboratory signs of hepatic cell injury was present in 66 patients. Serum bilirubin and transaminase levels were evaluated in 21 (31.81%) and 45 (68.19%) respectively, with a female preponderance. Early return to normal values occurred more frequently among alcoholic drinkers and non-cigarette smokers. Liver injury was characterized as being mild and moderate and the type of injury associated was represented by pure cholestasis and hepatocanalicular lesions. Probably, rifampicin is the drug responsible for this kind of evolution aggravating the hepatotoxicity induces by isoniazid and pyrazinamide.
巴西常用的肺结核抗结核治疗方案包括异烟肼（440毫克）、利福平（600毫克），均服用六个月，在前两个月加用吡嗪酰胺（2克）。这种治疗可能会在一些个体中诱发急性或慢性肝损伤。本研究的目的是评估1096例接受抗结核药物治疗的患者，其中男性773例，女性323例。66例患者出现肝细胞损伤的临床和实验室体征。分别对21例（31.81%）和45例（68.19%）患者进行了血清胆红素和转氨酶水平评估，女性占多数。饮酒者和不吸烟者中早期恢复正常水平的情况更为常见。肝损伤表现为轻度和中度，相关损伤类型以单纯胆汁淤积和肝小管病变为主。可能利福平是导致这种病情进展的药物，加重了异烟肼和吡嗪酰胺所致的肝毒性。
