肺结核药物性肝损害的相关因素分析

摘要

Objective To analyze the risk factors associated with anti-tuberculosis drug-induced liver injury in initial-treated patients with pulmonary tuberculosis. Methods Using historic parade study, a retrospective analy-sis of 620 patients with pulmonary tuberculosis was conducted from March 2010 to December 2014. It used a single factorχ2 test (P<0. 05) and non-conditional Logistic regression model to analyze the related factors of anti-TB drug-induced liver damage. Results The risk factors of liver damage caused by chemotherapy in patients with pulmonary tuberculosis included gender (OR=0. 166, CI0. 062 -0. 442), age (OR=2. 209, CI1. 468 -3. 326), history of alcoholism (OR=2. 165, CI1. 338 -3. 503), nutritional status (OR=2. 555, CI1. 399 -4. 665), HBV infection (OR=3. 13, CI1. 61-6. 085), unused liver drugs (OR=6. 349, CI3. 562-11. 319), and without immune drugs (OR=3. 614, CI1. 986-6. 576). Conclusion The risk factors of liver damage in patients with pulmonary tubercu-losis include male, age, malnutrition, alcoholism, HBV infection, unused liver drugs, and without immune drugs.%目的：分析肺结核初治患者化疗期间发生肝损害的相关因素。方法采用历史性列队研究，回顾性分析2010年3月-2014年12月初治肺结核病历资料592例，采用单因素χ2检验(P<0．05)和非条件Logistic回归模型对抗结核药物所致肝损害的相关因素进行分析。结果肺结核患者化疗引起肝损害的危险因素为性别( OR =0．166 CI 0．062-0．442)、年龄( OR =2．209 CI 1．468-3．326)、饮酒史( OR =2．165 CI1．338-3．503)、营养状况(OR=2．555 CI 1．399-4．665)、HBV感染者(OR=3．13 CI 1．61-6．085)、未使用护肝药物((OR=6．349 CI 3．562-11．319)、未使用免疫药物(OR=3．614 CI 1．986-6．576)结论男性、高龄、营养不良、嗜酒、HBV感染、未使用护肝和免疫药物，是抗结核药物性肝损害的危险因素。