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Xi Libin amine anti-tuberculosis drugs to prevent liver damage caused by clinical observation


[Paper Keywords] Xi Libin amine; prevention; tuberculosis; drug induced liver
[Abstract] Objective: To investigate the Xili Bin amine untreated sputum positive pulmonary tuberculosis on anti-tuberculosis drugs induced liver damage in patients with preventive effect. Methods: 242 patients with previously untreated sputum positive pulmonary tuberculosis were divided into study group and control group, all applications \Results: The incidence of drug induced liver group 6.6%, 4.1% interrupt anti-TB chemotherapy, chemotherapy adjusted rate was 1.6%; with the control group, 19.2%, 14.2% and 9.2% compared with significant difference (P TB patients receiving anti-tuberculosis drugs induced liver injury can occur during chemotherapy, can cause some patients then have to half-way stop, the impact of regular chemotherapy. Can effectively reduce or avoid chemotherapy and to be the occurrence of liver damage,[link widoczny dla zalogowanych], in recent years,[link widoczny dla zalogowanych], we untreated sputum positive pulmonary tuberculosis patients in the anti-TB drugs at the same time, I Xili Bin amine or Glucurolactone the same clothes to the prevention of drug induced liver injury and its effects were compared. Are reported as follows: 1 objects and methods 1.1 object 2001 年 1 month to December 2003 I have treated 242 cases of tuberculosis hospital patients, 167 cases of male and female 75 cases; aged 18 to 72 years; patients with the following conditions: ① the initial treatment of tuberculosis, clinical manifestations are fever, fatigue, night sweats, weight loss and other common symptoms of TB, X-ray film showed pulmonary infiltration of tuberculosis, sputum smear Check TB positive; ② sputum culture confirmed Mycobacterium tuberculosis to isoniazid (H), rifampicin (R), streptomycin (S),[link widoczny dla zalogowanych], ethambutol (E) and pyrazinamide (Z)-sensitive; ③ None of these drugs and the general history of antibiotic allergy; ④ no mental, neurological history; ⑤ no immune deficiency disease or history of immunosuppressive agents; ⑥ non-pregnant and lactating women; ⑦ mood, liver, kidney dysfunction and diabetes; ⑧ not alcohol use and nearly 3 weeks without fever, tranquilizers and other drugs that affect liver function; ⑨ patients agreed to treatment. Type of tuberculosis by 1998 standards [1], Ⅲ type 215 cases, Ⅲ + Ⅳ type in 27 cases. 242 cases were randomly divided into two groups; study group of 122 cases, male 84 cases, 38 female, aged 18 to 72 years, mean 37.2 years; the control group of 120 patients,[link widoczny dla zalogowanych], 83 males and 37 females, aged 19 70 years old, average 63.6 years old. Two middle-aged, serious condition, and the proportion of patients associated with underlying diseases are similar and comparable. 1.2 Methods chemotherapy: two groups were selected 2HRZS (E) / 4HR chemotherapy: H 300 mg, 1 times / d; R 450 mg, 1 times / d; Z 750 mg, 2 times / d ; S 750 mg1 times / d, or E 750 mg, 1 times / d, intramuscular injection. Observation group while taking Xili Bin amine (Yantai only the production of Chu Pharmaceutical Co., Ltd.) 50 ~ 100 mg, 3 times / d; the control group while taking Glucurolactone 200 mg, 3 times / d. Liver damage liver function tests to determine: the patients were in the check liver function before chemotherapy 2, to exclude primary liver disease and hepatitis B virus carriers; the strengthening of every 1 to 2 weeks to check 1; consolidation of the monthly check 1; chemotherapy such as nausea, vomiting, anorexia, abdominal distension and other symptoms, any review of liver function. To alanine aminotransferase (ALT)> 30 U / L as liver damage. 1.3 interrupt and re-adjustment of the standard anti-TB chemotherapy, standard chemotherapy regimens to ALT ≥ 90 U / L, and liver by short-term intensive treatment (treatment used to strengthen liver Ganlixin, inosine, vitamin C and other intravenous medicine, but the observation group continued to take Xili Bin amine) is still progressively increased after the ALT as interrupt the standard anti-TB chemotherapy; to apply the anti-tuberculosis drugs after severe liver dysfunction, and abnormal liver function to disable anti-TB drugs because of the parallel protection various indicators of normal liver after treatment, and to restore the original shortly after chemotherapy and abnormal liver function as a re-adjustment of the standard chemotherapy regimen.
2 results 2.1 compared to liver damage liver damage in the two groups occurred in the 1 to 8 weeks after chemotherapy,[link widoczny dla zalogowanych], including the observation group, 8 patients (6.6%), elevated aminotransferases, elevated in the range of 56 ~ 228 U; control group, 23 patients (19.2%), increased the range of 88 ~ 336 U. The two groups, the incidence of liver damage were significantly different (χ2 = 8.61, P <0.01). 2.2 chemotherapy regimens interrupted or re-adjustment of the comparison group interrupt chemotherapy observed in 5 patients (4.1%) in the control group were interrupted chemotherapy, 17 (14.2%), the two groups, the rate of interruption of chemotherapy Statistics School difference (χ2 = 7.42, P <0.01); the observation group were last adjusted chemotherapy, 2 patients (1.6%), chemotherapy in the control group were last adjusted in 11 patients (9.2%), the two groups, the final adjustment of chemotherapy rates were significantly different (χ2 = 6.74, P <0.01). 2.3 drug induced liver damage

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