中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2013年
9期
697-700
,共4页
药物性肝损伤%抗结核药%适应性
藥物性肝損傷%抗結覈藥%適應性
약물성간손상%항결핵약%괄응성
Drug-induced liver injury%Antitubercular agents%Adaptation
目的 探讨抗结核药物性肝损伤适应现象的临床特点.方法 依照药物性肝损伤诊断标准及其监测方案,采用病例登记和随访,从抗结核药物性肝损伤患者中筛选出适应现象病例32例.按出现药物性肝损伤后继续用药情况,分为持续用药和停药后再用药两组,依据生物化学指标和临床症状对肝损伤严重程度分级,探讨适应患者肝损伤类型、肝损伤与用药间的时间关系.计数资料用x2检验或确切概率法,计量资料用t检验,等级资料用秩和检验. 结果 在32例抗结核药物性肝损伤适应现象的住院病例中,持续用药者21例,停药后再用药者11例.32例适应患者均为肝细胞型肝损伤,潜伏期为(16.59±3.05)d,转氨酶峰值降低至正常水平的时间为(11.34±5.97)d.21例持续用药组患者潜伏期为(17.05±13.71)d,转氨酶峰值降低至正常水平时间为(11.20±5.92) d;11例停药后再用药组患者潜伏期为(16.46±12.09)d,转氨酶峰值降低至正常水平时间为(11.91±6.20)d.30例适应患者肝损伤程度为1级,2例患者肝损伤程度为2级. 结论 抗结核药物肝脏适应性变化的特点是肝脏生物化学指标暂时性升高,需要认识这种适应现象的变化规律,制定相应的监测和防治方案.
目的 探討抗結覈藥物性肝損傷適應現象的臨床特點.方法 依照藥物性肝損傷診斷標準及其鑑測方案,採用病例登記和隨訪,從抗結覈藥物性肝損傷患者中篩選齣適應現象病例32例.按齣現藥物性肝損傷後繼續用藥情況,分為持續用藥和停藥後再用藥兩組,依據生物化學指標和臨床癥狀對肝損傷嚴重程度分級,探討適應患者肝損傷類型、肝損傷與用藥間的時間關繫.計數資料用x2檢驗或確切概率法,計量資料用t檢驗,等級資料用秩和檢驗. 結果 在32例抗結覈藥物性肝損傷適應現象的住院病例中,持續用藥者21例,停藥後再用藥者11例.32例適應患者均為肝細胞型肝損傷,潛伏期為(16.59±3.05)d,轉氨酶峰值降低至正常水平的時間為(11.34±5.97)d.21例持續用藥組患者潛伏期為(17.05±13.71)d,轉氨酶峰值降低至正常水平時間為(11.20±5.92) d;11例停藥後再用藥組患者潛伏期為(16.46±12.09)d,轉氨酶峰值降低至正常水平時間為(11.91±6.20)d.30例適應患者肝損傷程度為1級,2例患者肝損傷程度為2級. 結論 抗結覈藥物肝髒適應性變化的特點是肝髒生物化學指標暫時性升高,需要認識這種適應現象的變化規律,製定相應的鑑測和防治方案.
목적 탐토항결핵약물성간손상괄응현상적림상특점.방법 의조약물성간손상진단표준급기감측방안,채용병례등기화수방,종항결핵약물성간손상환자중사선출괄응현상병례32례.안출현약물성간손상후계속용약정황,분위지속용약화정약후재용약량조,의거생물화학지표화림상증상대간손상엄중정도분급,탐토괄응환자간손상류형、간손상여용약간적시간관계.계수자료용x2검험혹학절개솔법,계량자료용t검험,등급자료용질화검험. 결과 재32례항결핵약물성간손상괄응현상적주원병례중,지속용약자21례,정약후재용약자11례.32례괄응환자균위간세포형간손상,잠복기위(16.59±3.05)d,전안매봉치강저지정상수평적시간위(11.34±5.97)d.21례지속용약조환자잠복기위(17.05±13.71)d,전안매봉치강저지정상수평시간위(11.20±5.92) d;11례정약후재용약조환자잠복기위(16.46±12.09)d,전안매봉치강저지정상수평시간위(11.91±6.20)d.30례괄응환자간손상정도위1급,2례환자간손상정도위2급. 결론 항결핵약물간장괄응성변화적특점시간장생물화학지표잠시성승고,수요인식저충괄응현상적변화규률,제정상응적감측화방치방안.
Objective To investigate the clinical characteristics of the adaptation phenomenon occurring in antituberculosis drug-induced liver injury.Methods Our department's clinical records were searched using the standardized diagnostic criteria and monitoring programs parameters of drug-induced liver injury to identify cases with the adaptation phenomenon.The 32 identified cases were classified according to whether or not the drug was discontinued after development of the drug-induced liver injury:withdrawal group (n =11) and continuing group (n =21).The types of patients with adaptation phenomenon were assessed to determine the relationship between liver injury and development time,and between the severity grade of liver injury (determined by biomarker expression) and symptoms.Results All of the 32 cases of drug-induced liver injury with the adaptation phenomenon were classified as the hepatocellular injury type.The average overall incubation period was 16.59 ± 13.05 days (range:6-60 days),while that of the continuing group was 17.05 ± 13.71 days (6-60 days) and that of the withdrawal group was 16.46 ± 12.09 days (6-43 days).The average overall time for peak transaminase levels to decrease to the normal range was 11.34 ± 5.97 days (6-30 days),while that of the continuing group was 11.20 ± 5.92 days (6-30 days) and that of the withdrawal group was 11.91 ± 6.20 days (7-30 days).Thirty of the overall patients showed grade 1 degree of liver injury and only two showed grade 2.Conclusion The clinical characteristics of the adaptation phenomenon include a transient increase in biochemical indicators of the antituberculosis drug-induced liver injury.It is important to understand the clinical variations in the adaptation phenomenon to formulate feasible and appropriate programs for monitoring and prevention.
