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中华实验和临床感染病杂志(电子版)

中华实验和临床感染病杂志(电子版) ›› 2017, Vol. 11 ›› Issue (03) : 260 -264. doi: 10.3877/cma.j.issn.1674-1358.2017.03.011

临床论著

抗结核药物对获得性免疫缺陷综合征合并结核病患者肝功能的影响
曹焕焕1()   
  1. 1. 523000　东莞市，广东省东莞市人民医院感染科
  • 收稿日期:2016-04-13 出版日期:2017-06-15
  • 通信作者: 曹焕焕
  • 基金资助:
    广东省自然科学基金博士科研启动项目(No. 2014A030310420); 广东省东莞市科学技术项目(No. 201350725000223)

Effect of anti-tuberculosis drugs on liver function of acquired immune deficiency syndrome patients complicated with tuberculosis

Huanhuan Cao1,†()   

  1. 1. Department of Infectious Diseases, People’s Hospital of Dongguan City, Guangdong Province, Dongguan 523000, China
  • Received:2016-04-13 Published:2017-06-15
  • Corresponding author: Huanhuan Cao
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曹焕焕. 抗结核药物对获得性免疫缺陷综合征合并结核病患者肝功能的影响[J/OL]. 中华实验和临床感染病杂志(电子版), 2017, 11(03): 260-264.

Huanhuan Cao. Effect of anti-tuberculosis drugs on liver function of acquired immune deficiency syndrome patients complicated with tuberculosis[J/OL]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2017, 11(03): 260-264.

目的

研究抗结核治疗对获得性免疫缺陷综合征合并结核病（AIDS/TB）患者肝功能的影响。

方法

纳入本院2013年4月至2015年8月收治的60例AIDS/TB患者（观察组）和60例单纯TB患者（对照组），两组患者均给予抗结核治疗，观察抗结核治疗后两组患者的肝功能指标变化、肝功能损伤以及不良反应。

结果

治疗前两组患者的TBil和ALT水平差异无统计学意义（t = 0.952、P = 0.343，t = 0.608，P = 0.544）；治疗后观察组患者TBil和ALT水平显著高于对照组（t = 10.110、P < 0.001，t = 26.098、P < 0.001）。观察组患者肝功能损伤比例高达46.7%，显著高于对照组（21.7%）（χ2 = 8.336、P = 0.004）。观察组患者肝功能损害出现时间显著短于对照组，而肝功能损伤恢复时间显著长于对照组（t = 11.970、P < 0.001，t = 9.693，P < 0.001）。观察组患者不良反应发生率为20.0%，显著高于对照组患者（8.3%），差异具有统计学意义（χ2 = 5.634、P < 0.001）。肝功能损伤患者CD4+ T细胞比例为（32.82 ± 4.67）%，无肝功能损伤患者CD4+ T细胞占（39.66 ± 4.85）%，差异具有统计学意义（t = 7.419、P < 0.001）。

结论

AIDS/TB患者抗结核治疗过程中对肝功能影响较大，更易发生肝功能损伤。

关键词: 获得性免疫缺陷综合征, 结核病, 抗结核治疗, 肝功能
Objective

To investigate the effect of anti-tuberculosis drugs on liver function of patients with acquired immune deficiency syndrome (AIDS) complicated with tuberculosis (TB).

Methods

Total of 60 patients with AIDS/TB hospitalized from April 2013 to August 2015 in our hospital were collected as the observation group, while 60 cases with TB were selected as the control group. Patients of both groups were treated with anti-tuberculosis drugs, and the indexes changes of liver function, liver function injury and adverse reactions after treatment were compared, respectively.

Results

The TBil and ALT levels of patients of both groups were with no significant differences before treatment (t = 0.952, P = 0.343; t = 0.608, P = 0.544). After treatment, the levels of TBil and ALT in patients of observation group were significantly higher than those of patients in control group (t = 10.110, P < 0.001; t = 26.098, P < 0.001). The proportion of liver damage of patients in observation group was 46.7%, which was significantly higher than that (21.7%) of the control group (χ2 = 8.336, P = 0.004). The period of liver function impairment of the observation group was significantly shorter than that of the control group, while the recovery period of liver function damage was significantly longer than that of the control group (t = 11.970, P < 0.001; t = 9.693, P < 0.001). The incidence of adverse reaction of patients in observation group was 20.0%, which was significantly higher than that (8.3%) of the control group (χ2 = 5.634, P < 0.001). The proportion of CD4+ T cells of patients with liver injury was (32.82 ± 4.67)%, and that of patients without liver damage was (39.66 ± 4.85)%, with significant difference (t = 7.419, P < 0.001).

Conclusions

During the course of anti-tuberculosis treatment, patients with AIDS/TB had a greater influence on liver function and were more likely to suffer from liver function damage.

Key words: Acquired immune deficiency syndrome, Tuberculosis, Anti-tuberculosis treatment, Liver function
表1 两组患者的TBil和ALT水平（ ± s）
组别 例数 TBil（μmol/L） ALT（IU/L）
治疗前 治疗后 治疗前 治疗后
对照组 60 7.6 ± 1.2 17.2 ± 5.1 32.2 ± 4.6 142.3 ± 16.8
观察组 60 7.8 ± 1.1 26.8 ± 5.3 31.7 ± 4.4 231.6 ± 20.5
t值   0.952 10.110 0.608 26.098
P值   0.343 < 0.001 0.544 < 0.001
表2 两组患者的肝功能损伤情况[例（%）]
组别 例数 轻度损伤 中度损伤 重度损伤 损伤比例
对照组 60 6（10.0） 5（8.3） 2（3.3） 13（21.7）
观察组 60 14（23.3） 9（15.0） 5（8.3） 28（46.7）
χ2值   3.840 1.294 1.365 8.336
P值   0.050 0.255 0.243 0.004
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