抗结核药物治疗所致肝损伤患者的危险因素及其治疗转归观察
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摘要
目的探讨抗结核药物治疗所致肝损伤患者的危险因素及其治疗转归。方法回顾性分析我院自2013年1月～2017年1月收治的1033例抗结核治疗患者的临床资料,其中158例患者发生抗结核药物所致肝损伤(DILD),统计分析所有患者性别、年龄、肝病史、酗酒、营养不良、痰菌情况。采用Logistics多因素回归分析法分析患者发生DILD的危险因素及治疗转归情况。结果1033例抗结核治疗患者中,出现DILD为158例,发生率15.30%,年龄、肝病史、酗酒、营养不良、痰菌阳性是DILD的危险因素(P<0.05);158例DILD患者经治疗后,治疗成功150例(94.94%),治疗失败8例(5.06%)。结论年龄、肝病史、酗酒、营养不良、痰菌阳性是DILD的危险因素,临床上应重点监测危险人群用药情况,及时调整治疗方案,降低DILD发生率,促使患者顺利完成化疗。
Objective To investigate the risk factors and treatment outcomes of patients with liver injury caused by anti-tuberculosis drugs. Methods The clinical data of 1033 anti-tuberculosis patients admitted to our hospital from January 2013 to January 2017 were retrospectively analyzed. Among them, 158 patients developed liver damage caused by anti-tuberculosis drugs(DILD), and all patients were statistically analyzed. Age, history of liver disease, alcoholism, malnutrition, and sputum. Logistics multivariate regression analysis was used to analyze the risk factors and treatment outcomes of patients with DILD. Results Among 1033 anti-tuberculosis patients, 158 cases had DILD, the incidence rate was 15.30%. Age, liver disease history,alcoholism, malnutrition, and sputum positive were risk factors for DILD(P<0.05). After treatment of 158 patients with DILD, 150 patients(94.94%)were successfully treated and 8 patients(5.06%) were treated with failure. Conclusion Age, liver disease history, alcoholism, malnutrition, and sputum positive are risk factors for DILD. Clinically, it is necessary to monitor the drug use of dangerous people, adjust the treatment plan in time,reduce the incidence of DILD, and prompt patients to successfully complete chemotherapy.
Objective To investigate the risk factors and treatment outcomes of patients with liver injury caused by anti-tuberculosis drugs. Methods The clinical data of 1033 anti-tuberculosis patients admitted to our hospital from January 2013 to January 2017 were retrospectively analyzed. Among them, 158 patients developed liver damage caused by anti-tuberculosis drugs(DILD), and all patients were statistically analyzed. Age, history of liver disease, alcoholism, malnutrition, and sputum. Logistics multivariate regression analysis was used to analyze the risk factors and treatment outcomes of patients with DILD. Results Among 1033 anti-tuberculosis patients, 158 cases had DILD, the incidence rate was 15.30%. Age, liver disease history,alcoholism, malnutrition, and sputum positive were risk factors for DILD(P<0.05). After treatment of 158 patients with DILD, 150 patients(94.94%)were successfully treated and 8 patients(5.06%) were treated with failure. Conclusion Age, liver disease history, alcoholism, malnutrition, and sputum positive are risk factors for DILD. Clinically, it is necessary to monitor the drug use of dangerous people, adjust the treatment plan in time,reduce the incidence of DILD, and prompt patients to successfully complete chemotherapy.
引文
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[7]陈诗娴,周玲,陈永忠,等.住院抗结核治疗患者药物性肝炎发生及转归研究[J].中华流行病学杂志,2016,37(7):930-934.
[2]戈启,杜亚东,聂文娟.55例抗结核药物所致重度肝损伤患者的临床分析[J].中国防痨杂志,2016,38(6):504-506.
[3]陈静,李亚利,梁欣,等.96例药物性肝损伤临床特点分析及危险因素探讨[J].临床药物治疗杂志,2017,15(2):19-23.
[4]李凌未,马凌飞,李胜前.412例抗结核药物导致肝损害的临床评价分析[J].药物流行病学杂志,2016,25(12):773-776.
[5]毛佳斌,孙培英,徐金田.初治肺结核患者药物性肝损伤的危险因素分析及对策[J].中华全科医学,2016,14(11):1867-1869.
[6]何涛,汪峰,唐武.抗结核药致药物性肝损伤危险因素的Logistic回归分析[J].中国药房,2016,27(12):1626-1628.
[7]陈诗娴,周玲,陈永忠,等.住院抗结核治疗患者药物性肝炎发生及转归研究[J].中华流行病学杂志,2016,37(7):930-934.