关键词: 结核,肺, 抗结核药, 肝炎

Abstract: Objective To observe the occurrence of the hepatitis resulted from antituberculous drugs and it’s impaction on the effect of antituberculosis.Methods The initial treatment smear-positive cases with normal liver function were treated with 2H₃R₃E₃Z₃/4H₃R₃ and reexamined liver function one time every month.The cases with the raise of ALT during the course of antituberculosis were reexamined liver function one time every week,The effect was assessed after they had completed their antituberculosis treatment.Results 1.The occurrence of the hepatitis resulted from antituberculous drugs was 23.1%,and which of the cases with primary liver diseases was 66.3%;2.Among the cases whose ALT in the first reexamination was 50 U/L～100 U/L,and who had neither hepatitis symptoms nor the raise of bilirubin,the 51.2% of them belonged to temporary raise of ALT;3.73.2% of the hepatitis resulted from antituberculous drugs occurred during the first 2 months,and 26.8% of which occurred during the late 4 months;4.There was no cases died of the hepatitis resulted from antituberculous drugs,the average recovering time of all the hepatitis resulted from antituberculous drugs was 2.3 weeks,and which of the cases with primary liver diseases was 3.9 weeks,which of the cases without primary liver diseases was 1.8 weeks;5.The total cure rate of pulmonary tuberculosis was 94.6%,which of the cases without the hepatitis resulted from antituberculous drugs was 97.0%,which of the cases with the hepatitis resulted from antituberculous drugs was 86.6%,and which of the cases with primary liver diseases was 78.6%.Conclusions 1.The hepatitis resulted from antituberculous drugs is an important impacting factor on the treatment effect of pulmonary tuberculosis,especial on which of the cases with primary liver diseases,such as the patients with HBsAg（+）,and 2H₃R₃E₃Z₃/4H₃R₃ should not be widely used in the patients who have primary liver diseases;2、Among the cases whose ALT in the first reexamination is 50 U/L～100 U/L,and who have neither hepatitis symptoms nor the raise of bilirubin,the 51.2% of them belong to temporary raise of ALT,and need not stop taking antituberculous drugs,but close observation of symptoms and regular reexamination of liver function is necessary;3.The hepatitis resulted from antituberculous drugs may occur during the whole course of antituberculosis treatment,but mainly during the enhanced antituberculosis period,so the treatment of protecting liver and the surveillance of liver function should be enhanced during the enhanced antituberculosis period.

Key words: Pulmonary tuberculosis, Antituberculous drugs, Hepatitis