乙肝表面抗原携带状态结核患者抗结核治疗对肝损害的影响分析

摘要/Abstract

摘要： 目的研究抗结核治疗中乙肝表面抗原携带状态与肝损害的关系。方法选择武汉市结核病医院乙肝表面抗原阳性的活动性结核,并接受了3个月以上的抗结核药物治疗的病例156例作为病例组,以接受了3个月以上的标准抗结核治疗的非乙肝表面抗原携带者141例为对照组。进行回顾性病例对照研究。结果乙肝病毒携带组出现中-重度肝损害的病人的比例较对照组显著高。在肝损害恢复后,即使是乙肝病毒携带者,再次使用一线抗结核药也是安全有效的。结论对于HB-sAg阳性,HBeAg阴性的非活动性乙肝携带者可以进行常规的抗结核治疗,在每个月进行肝功能检测的情况下,可以采用推荐的包括异烟肼,利福平,乙胺丁醇和/或吡嗪酰胺的抗结核治疗方案。

关键词: 抗结核药, 肝脏毒性, 肝炎,乙型

Abstract: Objective To determine whether inactive hepatitis B surface antigen(HBsAg) carriers are at a higher risk of drug-induced hepatotoxicity than control subjects during anti-tuberculosis treatment.Methods One hundred fifty-six inactive HBsAg carriers with newly diagnosed active tuberculosis who received standard anti-tuberculosis treatment were included in the study population.One hundred forty-one HBsAg negative patients who received standard anti-tuberculosis treatment were selected as control subjects.Results More severe hepatotoxicities were observed in cases than controls.After the hepatotoxicity was cured,HBsAg carriers can be treated with isoniazid,rifampin,ethambutol,and/or pyrazinamide again.Conclusion With monthly liver function examination,it is effective and safe for TB and non-active HBV co-infected patients to be treated with standard short-course regimens.

Key words: Anti-tuberculosis drug, Hepatotoxicity, Hepatitis B

陈志飞,韩丹,孙学智,. 乙肝表面抗原携带状态结核患者抗结核治疗对肝损害的影响分析[J]. 中国防痨杂志, 2007, 29(4): 343-346.

Chen Zhifei,Han Dan,Sun Xuezhi. The relationship between HBsAg carrier state and hepatotoxicity during anti-tuberculosis chemotherapy[J]. Chinese Journal of Antituberculosis, 2007, 29(4): 343-346.

参考文献

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