抗结核治疗合并HBV感染的结核病患者肝损害的发生与治疗

doi:10.3969/j.issn.1672-5069.2010.06.014

实用肝脏病杂志 ›› 2010, Vol. 13 ›› Issue (6): 438-440.doi: 10.3969/j.issn.1672-5069.2010.06.014

抗结核治疗合并HBV感染的结核病患者肝损害的发生与治疗

浦永兰,王杰,曹利峰,顾挺,李志勇

收稿日期:2010-09-30 出版日期:2010-12-10 发布日期:2016-04-18

The incidence and management of liver injuries in patients with tuberculosis complicated with hepatitis B viral infection during antituberculosis therapy

PU Yonglan，WANG Jie，CAO Lifeng，et al.

The Department of Infectious Disease，the First People’s Hospital，Taicang 215400，Jiangsu Province，China

Received:2010-09-30 Online:2010-12-10 Published:2016-04-18

摘要/Abstract

摘要： 目的探讨抗结核治疗合并HBV感染的结核病患者肝损害的发生与处理。方法将823例结核病患者分为不伴HBV感染（A组）、HBsAg阳性/HBV DNA阴性（B组）、HBsAg阳性/HBV DNA阳性（C组和D组）。A、B、C三组均采用抗结核治疗，D组在抗结核治疗前1周即加用核苷（酸）类似物抗病毒治疗，分析肝功能损害发生的特点。结果 A组、B组、C组和D组患者肝损害发生率分别为28.1%、32.1%、65.4%和29.2%，C组与其余三组比，相差显著（x2=16.97，P<0.001）；A组、B组、C组和D组患者半月内肝损害发生率分别为5.7%、22.2%、70.6%和14.3%，C组与其余三组比，相差显著（x2=67.66，P<0.001）。结论抗结核治疗合并HBV DNA阳性的结核病患者肝损害发生率高，发生时间早，肝损害程度重。及时应用核苷（酸）类似物抗病毒治疗，可明显降低肝损害发生率和程度。

关键词: 结核病, HbsAg, 肝损害, 核苷类似物

Abstract: Objective To observe incidence and management of liver injuries in patients with tuberculosis complicated with hepatitis B viral infection during antituberculosis therapy. Methods 823 patients with tuberculosis were divited into group A without HBV infection,group B with HBsAg positive and HBV DNA negative，and group C and D with HBsAg and HBV DNA positive. All patients received anti-tuberculosis therapy，except patients in group D who were treated with nucleoside analogue one week before anti-tuberculosis treatment. Results The incidence of liver injuries in four groups were 28.1%，32.1%，65.4% and 29.2%（P<0.001 as group C was compared with other three groups）；The incidence of liver injuries in four groups at an half month of treatment were 5.7%，22.2%，70.6% and 14.3%（P<0.001）.Conclusion The patients with tuberculosis and HBV infection have high incidence of liver damage during antituberculosis therapy. The administration of nucleoside analogue in time might decrease the incidence of liver injuries.

Key words: Tuberculosis, HbsAg, Liver injuries, Nucleoside analogue

浦永兰,王杰,曹利峰,顾挺,李志勇. 抗结核治疗合并HBV感染的结核病患者肝损害的发生与治疗[J]. 实用肝脏病杂志, 2010, 13(6): 438-440.

PU Yonglan，WANG Jie，CAO Lifeng，et al.. The incidence and management of liver injuries in patients with tuberculosis complicated with hepatitis B viral infection during antituberculosis therapy[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2010, 13(6): 438-440.

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抗结核治疗合并HBV感染的结核病患者肝损害的发生与治疗

The incidence and management of liver injuries in patients with tuberculosis complicated with hepatitis B viral infection during antituberculosis therapy

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