关键词: 抗结核药, 药物过敏, 预后

Abstract: Objective To explore the clinical characteristics and treatment strategies of anti-tuberculosis drug induced hypersensitivity. Methods Thirty-two cases with anti-tuberculosis drug induced hypersensitivity admitted to Jiangxi chest hospital from Jun.2006 to Dec.2012 were retrospectively analyzed, according to the clinical manifestation, laboratory test and prognosis (hypersensitivity group), and compared with those other 32 patients with allergic reaction but not hypersensitivity at the same period (non-hypersensitivity group). The categorical data were analyzed using t test by the SPSS 13.0 software. P value<0.05 was considered statistically significant. Results The symptoms of hypersensitivity group were fever,skin rash,abnormal liver and kidney function,thrombocytopeni（clinic manifestation），which were present earlier than in the comparison group((18.36±7.54) d vs (25.73±5.68) d), and significant differences were found between the two groups (t=4.41, P<0.01). Hospitalization time of hypersensitivity group was longer than the non-hypersensitive group ((34.23±9.37) d vs (16.71±5.25) d), the difference was statistically significant (t=9.23, P<0.01). Liver and kidney injury of hypersensitivity group were more serious than non-hypersensitive group (TBIL (122.36±75.74) μmol/L vs (18.35±7.16) μmol/L,DBIL (57.43±11.29) μmol/L vs (8.78±3.42) μmol/L,ALT (389.55±68.46) U/L vs (40.21±22.57) U/L,AST (294.81±53.72) U/L vs (38.77±14.86)U/L,CRE (155.27±86.43) μmol/L vs (89.12±29.37)μmol/L,BUN (9.39±6.72) mmol/L vs (5.28±1.75) mmol/L), significant differences were revealed between the two groups (t=7.73,23.40,27.39,25.99,4.09,3.34 respectively, P<0.01). Platelet count were lower in hypersensitivity group ((31.35±12.82)×10⁹/L vs (153.48±64.11)×10⁹/L), the difference between two groups was also significant (t=10.56，P<0.01).  Conclusion The anti-tuberculosis drug induced hypersensitivity is characterised by rapid onset, severe allergic reactions, multi-organ dysfunction and risk of mortality.Therefore， more attention should be paid to the hypersensitivity by TB medical staffs.

Key words: Antitubercular agents, Drug hypersensitivity, Prognosis