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Chinese Journal of Antituberculosis ›› 2014, Vol. 36 ›› Issue (1): 9-13.doi: 10.3969/j.issn.1000-6621.2014.01.003

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Impact of other liver diseases against TB drugs-induced liver injury and its prevention

LEI Jian-ping, DENG Guo-fang, LIU Zhou   

  1. Department of Tuberculosis Medicine, the Chest Hospital of Jiangxi Province,Nanchang 330008,China
  • Received:2013-09-13 Online:2014-01-10 Published:2014-01-05
  • Contact: LEI Jian-ping E-mail:Lei-jianping@vip.sina.com

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