关键词: 抗结核药, 肝炎, 中毒性, 肝疾病

Abstract: Objective  Study on the relationship between some foundation diseases in liver and antituberculosis drug-induced liver injury to approach the controlling and preventing measures.   Methods  For patients with other liver disease before anti-TB treatment, records the patient’s medical history and laboratory test results, development of appropriate anti-TB treatment regime to take measures to protect the liver. Assess effect of these measures in the treatment process of 1337 cases from January 2011 to December 2012. The data uses the card side examination; the measurement uses the t-test, carries on statistics analysis. P<0.05 means significance differences.   Results  Incidence of liver injury in patients with underlying disease of the liver (40.4%,116/287), was higher than patients without underlying disease (12.3%,129/1050);Merged incidence of liver injury in patients with hepatitis b (58.5%,83/142), above all of the cases (18.3%,245/1337), the differences were statistically significant respectively (χ²=16.2320, and 119.7547,P<0.01).The liver harm group B₁ group alanine aminotransferase (ALT) ≥8 times the upper limit of normal value (ULN) or (and) total bilirubin (TBIL) ≥ 4 times ULN is higher than the B₂ Group, the differences are statistically significant (χ²=7.9344, χ²=4.3033, P<0.01 or P<0.05).Group B₂ ALT, aspartate aminotransferase (AST), transformation of l-glutamine peptide enzyme (GGT), TBIL, direct bilirubin (DBIL) and indirect bilirubin (IBIL) ((173.8±197.0) IU/L,(113.3±208.6) IU/L,(74.5±73.4) IU/L,(22.3±84.9) μmol/L,(11.3±36.9) μmol/L,(10.7±25.4) μmol/L) are below B₁ ((343.4±235.4) IU/L,(270.7±246.6) IU/L,(115.5±83.5) IU/L,(84.6±102.6) μmol/L,(34.7±42.8) μmol/L,(30.5±30.7) μmol/L), and albumin (Alb) ((35.5±3.8) g/L) is higher than the B₁ Group ((32.5±3.7) g/L), the differences are statistically significant (t=3.9805,3.5226,2.6990,3.2093,3.8648,3.4089 and t′=4.0968, P-value <0.01 or <0.05).Treatment of group B₂ group interrupt rate is lower than B₁ (2/34,211/211) and the difference was statistically significant (χ²=220.2098, P<0.01).  Conclusion  The study suggests the some liver diseases can significantly increase the liver injury induced by anti-tuberculosis drugs, implementation of anti-TB treatment liver damage control measures can reduce the incidence of liver damage and reduce the rates of treatment interruption.

Key words: Antitubercular agents, Hepatitis, toxic, Liver diseases