结核与肺部疾病杂志 ›› 2023, Vol. 4 ›› Issue (2): 110-114.doi: 10.19983/j.issn.2096-8493.20220163

• 专题笔谈 • 上一篇    下一篇

重视结核病患者肝功能异常的鉴别诊断

戈启萍, 高孟秋()   

  1. 首都医科大学附属北京胸科医院结核二科,北京 101149
  • 收稿日期:2022-10-29 出版日期:2023-04-20 发布日期:2023-04-07
  • 通信作者: 高孟秋,Email:gaomqwdm@aliyun.com

Attach importance to the differential diagnosis of abnormal liver function in tuberculosis patients

Ge Qiping, Gao Mengqiu()   

  1. Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing 101149,China
  • Received:2022-10-29 Online:2023-04-20 Published:2023-04-07
  • Contact: Gao Mengqiu, Email:gaomqwdm@aliyun.com

摘要:

肝功能异常是结核病患者抗结核治疗过程中常见的药品不良反应。由于各型肝炎病毒、药物或毒物中毒、自身免疫性疾病、酒精性肝病、非酒精性脂肪性肝病、胆汁淤积等因素均可引起肝功能指标异常,肝功能异常的病因诊断有时会比较困难,往往需结合病史、生化、病原学、影像学,甚至肝脏穿刺活检病理学等检查方能明确诊断。临床上,结核病患者如出现肝功能异常,需快速、科学进行病因甄别并及时处理,对保障抗结核治疗的顺利进行并改善预后有重要作用。

关键词: 结核, 肝功能不全, 药物性肝损伤, 诊断,鉴别

Abstract:

Liver function injury is a common adverse drug reaction in the course of treatment of tuberculosis patients. Abnormal liver function can be caused by various types of hepatitis virus, drug or poison poisoning, autoimmune liver diseases, alcoholic liver disease, non-alcoholic fatty liver disease, cholestasis, et al.Sometimes it is difficult to diagnose the cause of liver injury. In clinical practice, it need to combine the history, biochemistry, etiology imaging and even liver biopsy to make a definite diagnosis. Clinically, in case of tuberculosis patients with abnormal liver function,it is necessary to identify the causes quickly and scientifically and intervene early meanwhile.It can contribute to the smooth progress of anti-tuberculosis treatment and improve the prognosis.

Key words: Tuberculosis, Hepatic insufficiency, Drug induced liver injury, Diagnosis, differential

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