个体化抗结核治疗对肺结核合并慢性HBV感染患者肝功能的影响

摘要

目的 探讨个体化抗结核治疗对肺结核合并慢性HBV感染肝功能的影响.方法 将84例初诊为肺结核合并慢性HBV感染的患者随机分为研究组和对照组,研究组依据药敏结果选择对肝功能影响较小的药物组成个体化治疗方案治疗,对照组采用抗结核标准治疗方案治疗,疗程结束后比较两组肝损害发生率、药物性肝损害发生时间及持续时间、抗结核治疗完成率及保肝治疗率.结果 研究组药物性肝损害发生率和保肝治疗率较对照组低(P＜0.05);研究组抗结核方案完成率高于对照组(P＜0.05);研究组首次发生肝功能损害的时间长于对照组,肝功能异常持续时间短于对照组(P＜0.05).结论 与标准抗结核方案比较,依据药敏试验结果个性化选择对肝功能影响较小的抗结核方案治疗对肺结核合并慢性HBV感染患者肝功能影响较小,具有明显的治疗优势.%Objective To investigate the effects of individualized anti-tuberculosis therapy on liver function in tuberculosis patients complicated with chronic HBV infection.Methods A total of 84 patients,newly diagnosed as tuberculosis complicated with chronic HBV infection,were randomly divided into study group and control group.The study group received the individualized anti-tuberculosis therapy, using the drugs with less effects on liver function based on the results of drug sensitivity test,while the control group received standard anti-tuberculosis regimen.The incidence rate of liver injury,the occurrence time and the duration for drug-induced liver injury,the completion rate of anti-tuberculosis treatment,and the rate of hepatoprotection treatment were compared between the two groups after treatment.Results The incidence rate of liver injury and the rate of hepatoprotection treatment in the study group were lower than those in the control group(P＜0.05);the completion rate of anti-tuberculosis treatment in the study group was higher than that in the control group(P＜0.05);after treatment,the liver injury occurred significantly later in the study group compared to the control group,however,the duration of liver dysfunction in the study group was shorter than that in the control group(P ＜0.05).Conclusion Compared with standard anti-tuberculosis regimen,the individualized anti-tuberculosis regimen,using the drugs with milder effects on liver function based on the results of drug sensitivity test,has a little effects on liver function of tuberculosis patients complicated with chronic HBV infection as well as obvious therapeutic advantages.