Risk factors and strategies of drug-induced liver injury in untreated pulmonary tuberculosis patients
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摘要: 目的 统计初治肺结核患者药物性肝损伤(drug-induced liver injury,DILI)的发生率,并分析患者发生肝损伤的危险致病因素。 方法 回顾性分析杭州师范大学附属医院2013年1月—2015年12月间收治且行抗结核药物治疗的620例肺结核病患者病例资料。根据有无发生肝损伤,将其分为有肝损伤组(117例)和无肝损伤组(503例)。制作危险因素调查表,收集性别、病程、年龄、饮酒史、吸烟史、肝炎史、糖尿病、血压水平、身体质量指数、保肝药服用等资料,采用单因素和Logistic回归分析对相关危险因素进行分析。 结果 肝损伤的发生率为18.9%。单因素分析结果显示:高龄、饮酒、吸烟、HbsAg阳性、高血糖、高血压、身体质量指数、未服用保肝药是初治肺结核患者发生DILI的危险因素。多因素Logistic回归分析结果显示:高龄、饮酒、吸烟、HbsAg阳性、高血糖、高血压、身体质量指数、未服用保肝药是初治肺结核患者发生DILI的危险因素。 结论 初治肺结核患者临床服用抗结核药物后,易发生DILI,而高龄、饮酒、吸烟、HbsAg阳性、糖尿病、高血压、身体质量指数、未服用保肝药是患者发生DILI的危险因素,应对这些因素进行高度重视,并给予个性化防治。Abstract: Objective To account the incidence of drug-induced liver injury(DILI) in untreated pulmonary tuberculosis patients,and investigate the risk factors of drug-induced liver injury. Methods All 620 cases of pulmonary tuberculosis patients in our hospital from January,2013 to December,2015 were retrospectively analyzed.The patients were divided into injury group(117 cases) and non-injury group(503 cases)based on drug-induced liver injury.The risk factors questionnaire included the following items:factors of gender,disease duration,age,drinking history,smoking history,HbsAg positive,diabetes,blood pressure level,Body mass index,using of protection liver drug.Univariate factor and Logistic regression analysis were carried out to analyze the related risk factors. Results The liver damage rate was 18.9%.Univariate analysis showed that the age,drinking history,smoking history,HbsAg positive,diabetes,blood pressure level,Body mass index,non-using of protection liver drug were the risk factors of DILI of pulmonary tuberculosis.And multivariate Logistic regression analysis showed that the age,drinking history,smoking history,HbsAg positive,diabetes,blood pressure level,Body mass index,non-using of protection liver drug were the risk factors of DILI of pulmonary tuberculosis. Conclusion Treatment naive patients with pulmonary tuberculosis easily occur DILI after the application of anti-TB drugs,and age,drinking history,smoking history,HbsAg positive,diabetes,blood pressure level,Body mass index,non-using of protection liver drug were the risk factors of drug-induced liver injury.These risk factors should be paid more attention.
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Key words:
- Tuberculosis /
- Anti-TB drugs /
- Liver damage /
- Risk factors
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