关键词: 结核,肺, 肝功能衰竭, 抗结核药物

Abstract: Objective To discuss the effect on liver failure caused by antitubercular drugs.Methods The 11 cases of acute liver failure ended death (death group) and 22 cases of severe liver function damage ended recovery (recovery group),both caused by antitubercular drugs,were analyses.Results The age, positive rate of HBsAg, the TBIL level and the time from the emergence of hepatitis symptom to the treatment of drug hepatitis in the death groups is significantly larger or higher or longer than those of recovery group (P<0.05).But the difference of ALT and AST level and the copies of HBV DNA level is not significant. The development of acute fulminant liver failure ended death was related to the following factors: aged patients, HBV infection before treatment, severe jaundice, ignorance and delayed treatment of liver function damage.Conclusion These cases of liver failure the need for stricter adherence to current guidelines on liver function tests after starting anti-tuberculous therapies. TBIL level and prothrombin activity (PTA) is more important indicators than ALT/AST in prognosis. Liver function damage with mainly abnormal ALT/AST and without elevated TBIL level can be recovered by stop using RFP and PZA plus administration of protective liver therapy.

Key words: Pulmonary tuberculosis, liver failure, Anti-tubercular drugs