本文關(guān)鍵詞： 艾滋病合并結(jié)核病人 抗結(jié)核藥物 肝損傷 預(yù)防　出處：《中國(guó)艾滋病性病》2015年05期 　論文類型：期刊論文

【摘要】：目的了解艾滋病(AIDS)病人使用保肝藥物,對(duì)標(biāo)化四聯(lián)抗結(jié)核(TB)治療中藥物性肝損傷的預(yù)防效果。方法回顧性分析采用標(biāo)化四聯(lián)抗結(jié)核治療的AIDS合并TB的住院病人(簡(jiǎn)稱AIDS/TB病人),對(duì)強(qiáng)化期內(nèi)使用保肝藥物預(yù)防(治療組)與未使用保肝藥物預(yù)防(對(duì)照組)的病人,比較兩者藥物性肝損傷的發(fā)生率。預(yù)防使用的保肝藥為還原型谷胱甘肽或復(fù)方甘草酸苷。有3種以上肝損傷危險(xiǎn)因素同時(shí)存在的病人,稱為肝損傷高危病人。結(jié)果符合條件的211例病例中,治療組122例,肝損傷發(fā)生率為13.1%(16例);對(duì)照組89例,肝損傷發(fā)生率為19.1%(17例);兩組比較肝損傷發(fā)生率差異無(wú)統(tǒng)計(jì)學(xué)意義(χ2=1.398、P0.05)。肝損傷高危病人134例,使用保肝藥物的86例,肝損傷發(fā)生率15.1%(13例),未使用保肝藥物的48例,肝損傷發(fā)生率為25.0%(12例),兩組比較無(wú)統(tǒng)計(jì)學(xué)意義(χ2=1.983、P0.05)。使用復(fù)方甘草酸苷65例,肝損傷發(fā)生率為13.8%(9例),使用還原型谷胱甘肽57例,肝損傷發(fā)生率為12.3%(7例),兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義(χ2=0.001、P0.05)。結(jié)論 AIDS/TB病人使用保肝藥物預(yù)防抗結(jié)核藥肝損傷效果不顯著,需靈活掌握治療方案。
[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.
【作者單位】： 南寧市第四人民醫(yī)院廣西艾滋病臨床治療中心;
【基金】：國(guó)家重大科技專項(xiàng)項(xiàng)目課題(2012ZX10004910-006) 南寧市科學(xué)研究與技術(shù)開發(fā)計(jì)劃項(xiàng)目(201109047C)~~
【分類號(hào)】：R512.91;R575
【正文快照】： 艾滋病(Acquired immune deficiency syndrome,AIDS)病人抗結(jié)核(Tuberculosis,TB)治療中易出現(xiàn)藥物性肝損傷,對(duì)病人預(yù)后影響大[1-2]。多數(shù)學(xué)者認(rèn)為:艾滋病病毒(Human immunodeficiency virus,HIV)感染是抗結(jié)核治療中藥物性肝損傷的高危因素,推薦保肝藥物預(yù)防[3]。本研究通過回

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1 E.Pukenyte;F.X.Lescure;D.Rey;C.Rabaud;B.Hoen;P.Chavanet;A.P.Laiskonis;J.L.Schmit;T.May;Y.Mouton;Y.Yazdanpanah;馬s，

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