贵阳市7043例结核病患者发生抗结核药物性肝损伤的危险因素分析

doi:10.3969/j.issn.2096-8493.20210094

摘要/Abstract

摘要：

目的分析抗结核药物所致肝损伤(ATB-DILI)的相关危险因素。方法回顾性收集2014年1月至2016年12月贵阳市公共卫生救治中心收治并进行随访的7043例结核病患者的临床资料,采用logistic回归分析患者年龄、性别、饮酒史、营养状态及并发基础肝病等相关资料中的危险因素。结果 7043例结核病患者中,319例(4.53%)患者发生了ATB-DILI,其中男性179例(56.11%),女性140例(43.89%)例。logistic 回归分析显示:≥60岁[OR(95%CI)=0.629(0.458~0.862),P=0.004]是发生ATB-DILI的保护因素;女性[OR(95%CI)=1.394(1.092~1.780),P=0.008]、现在饮酒[OR(95%CI)=2.222(1.569~3.148),P<0.001]、营养不良[OR(95%CI)=2.051(1.589~2.648),P<0.001]和并发基础肝病[OR(95%CI)=1.892(1.158~3.092),P=0.011]是发生ATB-DILI的危险因素。结论女性、<60岁、现在饮酒、营养不良及并发基础肝病的结核病患者是治疗期间发生ATB-DILI的高危人群,应针对该人群实施个体化抗结核方案。

关键词: 结核, 抗结核药, 药物性肝损伤, 危险因素

Abstract:

Objective To analyze the risk factors of anti-tuberculosis drug-induced liver injury (ATB-DILI). Methods The clinical data of 7043 tuberculosis (TB) patients admitted to Guiyang Public Health Treatment Center from January 2014 to December 2016 were retrospectively collected,all the patients were followed up. Logistic regression method was used to analyze the risk factors related to age, gender, drinking history, nutritional status and complicated underlying liver disease. Results Among the 7043 tuberculosis patients, ATB-DILI were found in 319 cases (4.53%) (male: 179 (56.11%), female: 140 (43.89%)).Logistic regression analysis showed that aged ≥60 years (OR (95%CI)=0.629 (0.458-0.862), P=0.004) was protective factor for ATB-DILI; female (OR (95%CI)=1.394 (1.092-1.780), P=0.008), current alcohol consumption (OR (95%CI)=2.222 (1.569-3.148), P<0.001), malnutrition (OR (95%CI)=2.051 (1.589-2.648), P<0.001) and complicated with underlying liver disease (OR (95%CI)=1.892 (1.158-3.092), P=0.011) were risk factors for ATB-DILI. Conclusion For tuberculosis patients, female, <60 years old, current alcohol consumption, malnutrition and complicated with underlying liver disease were high-risk groups for ATB-DILI during treatment, and individualized anti-tuberculosis programs should be implemented for these patients.

Key words: Tuberculosis, Antitubercular agents, Drug-induced liver injury, Risk factors

陈静, 赵鹏. 贵阳市7043例结核病患者发生抗结核药物性肝损伤的危险因素分析[J]. 结核与肺部疾病杂志, 2021, 2(4): 335-339. doi: 10.3969/j.issn.2096-8493.20210094

CHEN Jing, ZHAO Peng. Analysis of risk factors of anti-tuberculosis drug-induced liver injury in 7043 tuberculosis patients in Guiyang[J]. Journal of Tuberculosis and Lung Disease, 2021, 2(4): 335-339. doi: 10.3969/j.issn.2096-8493.20210094

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因素	非ATB-DILI组(6724例)	ATB-DILI组(319例)	χ²值	P值
年龄组(岁)			4.581	0.032
<60	5361(79.73)	270(84.63)
≥60	1363(20.27)	49(15.37)
性别			2.568	0.109
男性	4075(60.60)	179(56.11)
女性	2649(39.40)	140(43.89)
饮酒史			24.429	<0.001
从不饮酒	5983(88.98)	268(84.01)
曾经饮酒	209(3.11)	3(0.94)
现在饮酒	532(7.91)	48(15.05)
因素	非ATB-DILI组(6724例)	ATB-DILI组(319例)	χ²值	P值
营养不良			32.423	<0.001
无	5611(83.45)	227(71.16)
有	1113(16.55)	92(28.84)
并发基础肝病			8.859	0.003
无	6523(97.01)	300(94.04)
有	201(2.99)	19(5.96)
使用护肝药物			1.659	0.198
否	3272(48.66)	167(52.35)
是	3452(51.34)	152(47.65)