保肝药对AIDS合并TB病人抗结核治疗中药物性肝损伤的预防效果分析

发布时间：2018-02-02 06:28

本文关键词： 艾滋病合并结核病人抗结核药物肝损伤预防　出处：《中国艾滋病性病》2015年05期 　论文类型：期刊论文

【摘要】：目的了解艾滋病(AIDS)病人使用保肝药物,对标化四联抗结核(TB)治疗中药物性肝损伤的预防效果。方法回顾性分析采用标化四联抗结核治疗的AIDS合并TB的住院病人(简称AIDS/TB病人),对强化期内使用保肝药物预防(治疗组)与未使用保肝药物预防(对照组)的病人,比较两者药物性肝损伤的发生率。预防使用的保肝药为还原型谷胱甘肽或复方甘草酸苷。有3种以上肝损伤危险因素同时存在的病人,称为肝损伤高危病人。结果符合条件的211例病例中,治疗组122例,肝损伤发生率为13.1%(16例);对照组89例,肝损伤发生率为19.1%(17例);两组比较肝损伤发生率差异无统计学意义(χ2=1.398、P0.05)。肝损伤高危病人134例,使用保肝药物的86例,肝损伤发生率15.1%(13例),未使用保肝药物的48例,肝损伤发生率为25.0%(12例),两组比较无统计学意义(χ2=1.983、P0.05)。使用复方甘草酸苷65例,肝损伤发生率为13.8%(9例),使用还原型谷胱甘肽57例,肝损伤发生率为12.3%(7例),两组比较差异无统计学意义(χ2=0.001、P0.05)。结论 AIDS/TB病人使用保肝药物预防抗结核药肝损伤效果不显著,需灵活掌握治疗方案。
[Abstract]:Objective to investigate the use of hepatoprotective drugs in patients with HIV / AIDS (AIDS). The preventive effect of drug induced liver injury in standard tetradrug antituberculous therapy was analyzed retrospectively in patients with AIDS combined with TB treated with standardized antituberculous therapy (TTB). Short for AIDS/TB patient). Patients who were treated with hepatoprotective drugs (treatment group) and those who did not use hepatoprotective drugs (control group) during the intensive period. To compare the incidence of drug-induced liver injury between the two groups. The hepatic protective agents used for prevention were reduced glutathione or compound glycyrrhizin. There were more than three risk factors for liver injury in patients. Results among 211 patients with high risk of liver injury, 122 cases were in the treatment group, and the incidence of liver injury was 13. 1% and 16 cases respectively. In the control group, the incidence of liver injury was 19. 1% and 17 cases respectively. There was no significant difference in the incidence of liver injury between the two groups (蠂 ~ 2 ~ (2) 1.398A, P 0.05). 134 patients with high risk of liver injury and 86 patients with liver protection drugs were treated. The incidence of liver injury was 15.1g / L in 13 cases and in 48 cases not treated with hepatoprotective drugs. The incidence of liver injury was 25.0% (12 / 12). There was no significant difference between the two groups (蠂 ~ 2 / 1.983). 65 cases were treated with compound glycyrrhizin, 9 cases with liver injury, 57 cases with reduced glutathione, and 7 cases with liver injury. There was no significant difference between the two groups (蠂 2 0.001 P 0.050.Conclusion there is no significant effect of antituberculotic liver injury in patients with AIDS/TB using hepatoprotective drugs. It is necessary to master the treatment plan flexibly.
【作者单位】：南宁市第四人民医院广西艾滋病临床治疗中心;
【基金】：国家重大科技专项项目课题(2012ZX10004910-006) 南宁市科学研究与技术开发计划项目(201109047C)~~
【分类号】：R512.91;R575
【正文快照】： 艾滋病(Acquired immune deficiency syndrome,AIDS)病人抗结核(Tuberculosis,TB)治疗中易出现药物性肝损伤,对病人预后影响大[1-2]。多数学者认为:艾滋病病毒(Human immunodeficiency virus,HIV)感染是抗结核治疗中药物性肝损伤的高危因素,推荐保肝药物预防[3]。本研究通过回

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