抗结核药物治疗患者肝毒性的预防和监测

F. Hsiao, Y. Yen, Chun-Nin Lee, Weng‐Foung Huang, Hsiang-Yin Chen
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摘要

抗结核治疗经常引起肝毒性。本研究旨在评价抗结核治疗期间肝功能监测的适宜性。纳入了245例接受抗结核药物治疗的患者。基线肝功能(LFT)异常是治疗期间发生肝毒性的最重要危险因素(调整后OR为23.48;95% ci: 9.74-56.61)。然而,在肝毒性组中,仅76.2%和75.4%的受试者检查了基线天冬氨酸转氨酶(AST)和丙氨酸转氨酶(ALT)水平;而非肝毒性组则更低,分别为58.5%和57.8%。虽然吸烟、重度饮酒、年龄、性别和并发疾病是显著的危险因素,但logistic回归显示只有基线LFT异常(调整OR为2.21;95% CI: 1.22-4.02)和年龄(调整OR 1.02;95% CI: 1.01-1.04)是患者接受随访肝功能检查(LFTs)的决定因素。应建立有效的策略来改善肝功能监测,以确保患者的安全。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prevention and Monitoring of Hepatotoxicity among Patients Receiving Antituberculosis Medications
Antituberculosis therapy frequently causes hepatotoxicity. The study is to evaluate the appropriateness of liver function monitoring during antituberculosis therapy. Two hundred forty five patients treated with antituberculosis agents were included. Abnormal baseline liver function (LFT) was the most significant risk factor for developing hepatotoxicity during the therapy (adjusted OR 23.48; 95% CI: 9.74-56.61). However, the baseline aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were only checked in 76.2% and 75.4% subjects in the hepatotoxic group; and even lower to 58.5% and 57.8% for the non-hepatotoxic group. Although smoking, severe drinking, age, gender and concurrent diseases were significant risk factors, the logistic regression showed that only abnormal baseline LFT (adjusted OR 2.21; 95% CI: 1.22-4.02) and age (adjusted OR 1.02; 95% CI: 1.01-1.04) were determinants of patients receiving follow-up liver function tests (LFTs). Effective strategies to improve the monitoring of liver function should be established to ensure patient safety.
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