中国药业
中國藥業
중국약업
CHINA PHARMACEUTICALS
2015年
1期
89-90,91
,共3页
硫普罗宁%乙型病毒性肝炎%肺结核%药物性肝损害%疗效
硫普囉寧%乙型病毒性肝炎%肺結覈%藥物性肝損害%療效
류보라저%을형병독성간염%폐결핵%약물성간손해%료효
tiopronin%hepatitis B%pulmonary tuberculosis%drug-induced liver damage%curative efficacy
目的：观察硫普罗宁在乙型病毒性肝炎(简称乙肝)并肺结核患者抗结核保肝治疗中的临床效果。方法选取收治的85例乙肝并肺结核患者，随机分为观察组（44例）与对照组（41例）。对照组给予2H3R3Z3E3/4H3R3标准抗结核化疗方案，同时予常规保肝治疗；观察组在此基础上强化期内加服硫普罗宁片，对比治疗后两组肝功能变化与抗结核治疗效果。结果治疗2~8周内，观察组与对照组分别有8例(18.18%)和14例(34.15%)丙氨酸氨基转移酶（ALT）超过80 U/L（χ2=2.820，P=0.093），其中各有1例（2.27%）和6例（14.63%）ALT超过120 U/L（fisher，P=0.045）；治疗满6个月，观察组ALT、天门冬氨酸氨基转移酶（AST）、总胆红素（TBIL）均明显低于对照组（ P<0.05）；观察组抗结核治疗中空洞闭合率（89.47%比72.22%）、病灶吸收率（95.45%比78.05%）、痰菌阴转率（90.91%比75.61%）均高于对照组，其中病灶吸收率差异有统计学意义（χ2=5.707，P=0.017）；两组药品不良反应主要为肝损害、皮肤瘙痒、皮疹，发生率（11.36%比14.63%）差异无统计学意义（χ2=3.306，P=0.069）。结论乙肝并肺结核患者抗结核保肝治疗强化期内加服硫普罗宁，能有效降低药物性肝损害发生率，有助于提高抗结核疗效，具有较高的临床安全性。
目的：觀察硫普囉寧在乙型病毒性肝炎(簡稱乙肝)併肺結覈患者抗結覈保肝治療中的臨床效果。方法選取收治的85例乙肝併肺結覈患者，隨機分為觀察組（44例）與對照組（41例）。對照組給予2H3R3Z3E3/4H3R3標準抗結覈化療方案，同時予常規保肝治療；觀察組在此基礎上彊化期內加服硫普囉寧片，對比治療後兩組肝功能變化與抗結覈治療效果。結果治療2~8週內，觀察組與對照組分彆有8例(18.18%)和14例(34.15%)丙氨痠氨基轉移酶（ALT）超過80 U/L（χ2=2.820，P=0.093），其中各有1例（2.27%）和6例（14.63%）ALT超過120 U/L（fisher，P=0.045）；治療滿6箇月，觀察組ALT、天門鼕氨痠氨基轉移酶（AST）、總膽紅素（TBIL）均明顯低于對照組（ P<0.05）；觀察組抗結覈治療中空洞閉閤率（89.47%比72.22%）、病竈吸收率（95.45%比78.05%）、痰菌陰轉率（90.91%比75.61%）均高于對照組，其中病竈吸收率差異有統計學意義（χ2=5.707，P=0.017）；兩組藥品不良反應主要為肝損害、皮膚瘙癢、皮疹，髮生率（11.36%比14.63%）差異無統計學意義（χ2=3.306，P=0.069）。結論乙肝併肺結覈患者抗結覈保肝治療彊化期內加服硫普囉寧，能有效降低藥物性肝損害髮生率，有助于提高抗結覈療效，具有較高的臨床安全性。
목적：관찰류보라저재을형병독성간염(간칭을간)병폐결핵환자항결핵보간치료중적림상효과。방법선취수치적85례을간병폐결핵환자，수궤분위관찰조（44례）여대조조（41례）。대조조급여2H3R3Z3E3/4H3R3표준항결핵화료방안，동시여상규보간치료；관찰조재차기출상강화기내가복류보라저편，대비치료후량조간공능변화여항결핵치료효과。결과치료2~8주내，관찰조여대조조분별유8례(18.18%)화14례(34.15%)병안산안기전이매（ALT）초과80 U/L（χ2=2.820，P=0.093），기중각유1례（2.27%）화6례（14.63%）ALT초과120 U/L（fisher，P=0.045）；치료만6개월，관찰조ALT、천문동안산안기전이매（AST）、총담홍소（TBIL）균명현저우대조조（ P<0.05）；관찰조항결핵치료중공동폐합솔（89.47%비72.22%）、병조흡수솔（95.45%비78.05%）、담균음전솔（90.91%비75.61%）균고우대조조，기중병조흡수솔차이유통계학의의（χ2=5.707，P=0.017）；량조약품불량반응주요위간손해、피부소양、피진，발생솔（11.36%비14.63%）차이무통계학의의（χ2=3.306，P=0.069）。결론을간병폐결핵환자항결핵보간치료강화기내가복류보라저，능유효강저약물성간손해발생솔，유조우제고항결핵료효，구유교고적림상안전성。
Objective To observe and discuss the clinical efficacy of tiopronin in the anti-tuberculosis ( TB ) liver-protecting therapy in the patients with hepatitis B complicating pulmonary TB. Methods 85 cases of hepatitis B complicating pulmonary tuberculosis were selected as the research subjects and randomized into the observation group ( n=44 ) and the control group ( n=41 ) . The control group was given the standardized anti-TB chemotherapeutical scheme ( 2H3R3Z3E3/4H3R3 ) and simultaneous conventional liver-protecting therapy, while on this basis the observation group was added with oral tiopronin during the intensive treatment period. The changes of liver function and the efficacy of anti-TB treatment after treatment were compared between the 2 groups. Results The ALT level exceeding 80 U/L within 2-8 weeks of treatment had 8 cases ( 18. 18%) in the observation group and 14 cases ( 34. 15%) in the control group (χ2=2. 820, P=0. 093 );among them the ALT level exceeding 120 U/L had 1 case ( 2. 27% ) and 6 cases ( 14. 63% ) respectively ( Fisher P=0. 045 ) . The ALT, AST and TBiL levels after 6-month treatment in the observation group were significantly lower than those in the control group( P<0. 05);the cavity closure ratio, focus absorption ratio and sputum bacterial negative conversion rate by the anti-TB therapy in the observation group were higher than those in the control group respectively ( 89. 47% vs. 72. 22%;95. 45% vs. 78. 05%and 90. 91% vs. 75. 61% ) , in which the difference in the focus absorption ratio had statistical significance (χ2=5. 707, P=0. 017 );the adverse reactions in the two groups were mainly liver damage, skin itching and skin rash;their occurrence rates ( 11. 36% vs. 14. 63% ) had no statistical difference between the two groups (χ2=3. 306, P=0. 069 ) . Conclusion Adding oral tiopronin during the intensive pe-riod of anti-TB liver-protecting therapy can effectively reduce the incidence probability of drug-induced liver damage in the patients with hepatitis B complicating pulmonary TB, contribute to improve the anti-TB efficacy and has higher clinical safety.
