Abstract: Objective The aim of this study was to explore the supplement of human blood albumin products in reducing the incidence of drug-induced liver injury (DILI) in patients with pulmonary tuberculosis ans hypoproteinemia. Methods 56 patients with pulmonary tuberculosis and hypoproteinemia were encountered in the Department of Infectious Diseases, Shantou Central Hospital between March 2019 and March 2021, and were divided into control (n=28) and observation (n=28) groups. All patients were treated with the anti-tuberculosis regimen, e.g. 2HRZE/4HR, and those in the observation group was additionally given human blood albumin product infusion. The anti-tuberculosis treatment lasted for six months, and the patients with DILI received liver-protecting medicine appropriately. Serum albumin (ALB), aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and total bilirubin (TBIL) levels were detected by fully automated biochemical Analyzer, and serum total bile acid (TBA) level was detected by chemiluminescence. The clinical outcomes were evaluated by CT scan and sputum specimen culture and the incidence of DILI was recorded. Results The total effective rate in the observation group was 92.9%, significantly higher than 71.4% (P<0.05) in the control group; the negative rate of sputum bacteria in the observation group was 91.3%, significantly higher than 66.7% (P<0.05) and the absorption of lung lesions was 89.3%, significantly higher than 64.3%(P<0.05) in the control; during the period of anti-tuberculosis, the incidence of DILI in the observation group was 25.0%, significantly lower than 53.6%(P<0.05) in the control; when the DILI occurred, serum ALB level in the 7 patients in the observation group was (35.2±4.9)g/L, significantly higher than [(29.6±4.9)g/L, P<0.05], while serum bilirubin level was (33.6±5.2)μmol/L, significantly lower than [(45.7±16.6)μmol/L, P<0.05] in 15 patients in the control; after the liver-protecting treatment, serum AST, ALT, ALP, TBIL and TBA levels in the observation were (39.4±9.8)U/L, (35.1±10.8)U/L, (98.6±16.2)U/L, (17.4±4.6)μmol/L and (81.3±13.7)μmol/L, all significantly lower than [(64.8±9.9)U/L, (78.0±13.8)U/L, (133.7±22.9)U/L, (26.5±6.8)μmol/L and (96.9±16.4)μmol/L, respectively, P<0.05] in the control. Conclusion Our observation suggest that the infusion of human blood albumin product in time to correct hypoalbuminemia in patients with pulmonary tuberculosis could reduce the incidence of DILI, and improve the recovery of tuberculosis.

Key words: Drug-induced liver injury, Pulmonary tuberculosis, Hypoproteinemia, Anti-tuberculous medicines, Human blood albumin products, Therapy