Please wait a minute...
文章检索
预防医学  2022, Vol. 34 Issue (2): 114-118    DOI: 10.19485/j.cnki.issn2096-5087.2022.02.002
  论著 本期目录 | 过刊浏览 | 高级检索 |
宁波市肺结核患者药物性肝损伤的影响因素研究
杨天池1, 李舒婷2, 陈琴3, 陈同1, 车洋1
1.宁波市疾病预防控制中心结核病防制所,浙江 宁波 315010;
2.宁波大学,浙江 宁波 315211;
3.中国科学院大学宁波华美医院,浙江 宁波 315010
Influencing factors for drug-induced liver injury among patients with pulmonary tuberculosis in Ningbo City
YANG Tianchi1, LI Shuting2, CHEN Qin3, CHEN Tong1, CHE Yang1
1. Department of Tuberculosis Control and Prevention, Ningbo Center for Disease Control and Prevention, Ningbo, Zhejiang 315010, China;
2. Ningbo University, Ningbo, Zhejiang 315211, China;
3. Ningbo Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang 315010, China
全文: PDF(803 KB)  
输出: BibTeX | EndNote (RIS)      
摘要 目的 分析2015—2019年宁波市肺结核患者药物性肝损伤的影响因素,为预防药物性肝损伤提供依据。方法 通过中国疾病预防控制信息系统结核病管理信息系统和宁波市区域诊疗信息平台收集2015—2019年宁波市肺结核患者人口学资料、药物性肝损伤发生情况和抗结核药物治疗前疾病史等资料。采用多因素logistic回归模型分析药物性肝损伤的影响因素。结果 纳入肺结核患者9 397例,男性6 242例,占66.43%;<60岁6 192例,占65.89%;初治8 678例,占92.35%。发生药物性肝损伤1 425例,发生率为15.16%。肝损伤1级729例,占51.16%;2级24例,占1.68%;3级7例,占0.49%;4级7例,占0.49%;未分级658例,占46.18%。药物性肝损伤发生间隔时间的MQR)为24(44)d。多因素logistic回归分析结果显示,初治(OR=1.464,95%CI:1.153~1.859)和肝病史(OR=2.001,95%CI:1.709~2.342)是肺结核患者药物性肝损伤的危险因素。结论 2015—2019年宁波市肺结核患者药物性肝损伤发生率为15.16%,初治和肝病史与药物性肝损伤有关。
服务
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章
杨天池
李舒婷
陈琴
陈同
车洋
关键词 肺结核药物性肝损伤影响因素    
AbstractObjective To investigate the factors affecting drug-induced liver injury among patients with pulmonary tuberculosis in Ningbo City from 2015 to 2019, so as to provide insights into the prevention of drug-induced liver injury. Methods Demographic features, presence of drug-induced liver injury, and disease history prior to anti-tuberculosis therapy were captured from patients with pulmonary tuberculosis in Ningbo City from 2015 to 2019 through the Tuberculosis Management Information System of the Chinese Disease Control and Prevention Information System and Ningbo Regional Diagnosis and Treatment Information Platform. Factors affecting drug-induced liver injury was identified using the multivariable logistic regression analysis. Results A total of 9 397 patients with pulmonary tuberculosis were enrolled, among whom 66.43% ( 6 242 case ) were male, 65.89% ( 6 192 cases ) were at ages of <60 years, and 92.35% ( 8 678 cases ) were treatment-naïve. There were 1 425 patients with drug-induced liver injury (15.16% incidence), including 729 cases with grade 1 (51.16%), 24 cases with grade 2 (1.68%), 7 cases with grade 3 (0.49%), 7 cases with grade 4 ( 0.49% ), and 658 cases with ungraded drug-induced liver injury ( 46.18% ). The median duration between drug administration and development of drug-induced liver injury was 24 ( interquartile range, 44 ) days. Multivariable logistic regression analysis identified treatment-naïve ( OR=1.464, 95%CI: 1.153-1.859 ) and history of liver disease ( OR=2.001, 95%CI: 1.709-2.342) as risk factors for drug-induced liver injury in patients with pulmonary tuberculosis. Conclusion The incidence of drug-induced liver injury was 15.16% among pulmonary tuberculosis patients in Ningbo City from 2015 to 2019. Treatment-naïve and a history of liver disease are associated with drug-induced liver injury among patients with pulmonary tuberculosis.
Key wordspulmonary tuberculosis    drug-induced liver injury    influencing factor
收稿日期: 2021-08-19      修回日期: 2021-10-09      出版日期: 2022-02-10
中图分类号:  R378.91  
基金资助:浙江省医药卫生项目(2018KY733); 宁波市自然科学基金项目(2019A610386,2019A610385); 宁波市医疗卫生品牌学科(PPXK2018-10)
通信作者: 杨天池,E-mail:57237243@qq.com   
作者简介: 杨天池,硕士,主任医师,主要从事结核病防治工作
引用本文:   
杨天池, 李舒婷, 陈琴, 陈同, 车洋. 宁波市肺结核患者药物性肝损伤的影响因素研究[J]. 预防医学, 2022, 34(2): 114-118.
YANG Tianchi, LI Shuting, CHEN Qin, CHEN Tong, CHE Yang. Influencing factors for drug-induced liver injury among patients with pulmonary tuberculosis in Ningbo City. Preventive Medicine, 2022, 34(2): 114-118.
链接本文:  
http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2022.02.002      或      http://www.zjyfyxzz.com/CN/Y2022/V34/I2/114
[1] LOW E,ZHENG Q,CHAN E,et al.Drug induced liver injury:East versus West-a systematic review and meta-analysis[J].Clin Mol Hepatol,2020,26(2):142-154.
[2] 中华医学会结核病学分会.抗结核药物性肝损伤诊治指南(2019年版)[J].中华结核和呼吸杂志,2019,42(5):343-356.
Chinese Medical Association Tuberculosis Branch.Guidelines for the diagnosis and treatment of anti-tuberculosis drug-induced liver injury(2019 edition)[J].Chin J Tuberc Respir Dis,2019,42(5):343-356.
[3] SHEN T,LIU Y,SHANG J,et al.Incidence and etiology of drug-induced liver injury in Mainland China[J].Gastroenterology,2019,156(8):2230-2241.
[4] 中华人民共和国卫生部.肺结核诊断标准:WS 288—2008[S].2008.
Ministry of Health of the People's Republic of China.Diagnostic criteria for pulmonary tuberculosis:WS 288-2008[S].2008.
[5] 中华人民共和国国家卫生和计划生育委员会.肺结核诊断:WS 288—2017[S].2017.
National Health and Family Planning Commission of the People's Republic of China.Diagnostic for pulmonary tuberculosis:WS 288-2017[S].2017.
[6] 中华医学会结核病学分会,《中华结核和呼吸杂志》编辑委员会.抗结核药所致药物性肝损伤诊断与处理专家建议[J].中华结核和呼吸杂志,2013,36(10):732-736.
Chinese Medical Association Tuberculosis Branch,Chinese Journal of Tuberculosis and Respiration Editorial Committee.Expert advice on the diagnosis and treatment of drug-induced liver injury caused by anti-tuberculosis drugs[J].Chin J Tuberc Respir Dis,2013,36(10):732-736.
[7] 刘亚洁,张燕,陈阳贵,等.SLC11A1基因多态性与肺结核治疗失败的关联分析[J].预防医学,2021,33(6):563-567.
LIU Y J,ZHANG Y,CHEN Y G,et al.The association between SLC11A1 gene polymorphism and treatment failure of pulmonary tuberculosis[J].Prev Med,2021,33(6):563-567.
[8] 王云霞,郑娟娟,张娟娟,等.2011—2018年宝安区肺结核患者耐多药的影响因素分析[J].预防医学,2021,33(7):701-703.
WANG Y X,ZHENG J J,ZHANG J J,et al.Influencing factors of multidrug resistance of patients with tuberculosis in Baoan District from 2011 to 2018[J].Prev Med,2021,33(7):701-703.
[9] 刘芳,臧珊珊,刘永梅,等.抗结核治疗致肺结核患者药物性肝损伤的危险因素分析[J].解放军医药杂志,2019,31(9):56-59.
LIU F,ZANG S S,LIU Y M,et al.Risk factors of drug-induced hepatic injury in tuberculosis patients after anti-tuberculosis therapy[J].Med Pharm J Chin PLA,2019,31(9):56-59.
[10] 迟旭,漆沄,陈娟,等.初次抗结核治疗诱发药物性肝损伤临床特点及发病危险因素的logistic回归分析[J].陕西医学杂志,2019,48(1):67-70.
CHI X,QI Y,CHEN J,et al.Logistic regression analysis of the clinical characteristics and risk factors of drug-induced liver injury induced by the first anti-tuberculosis treatment[J].Shaanxi Med J,2019,48(1):67-70.
[11] ZHAO H,WANG Y B,ZHANG T,et al.Drug-induced liver injury from anti-tuberculosis treatment:a retrospective cohort study[J].Med Sci Monit,2020,26[2021-10-09].https://pubmed.ncbi.nlm.nih.gov/32145061.DOI:10.12659/MSM.920350.
[12] XU L,CHEN J,INNES A L,et al.Prescription practice of anti-tuberculosis drugs in Yunnan,China:a clinical audit[J].PLoS One,2017,12(10)[2021-10-09].https://pubmed.ncbi.nlm.nih.gov/29088241.DOI:10.1371/journal.pone.0187076.
[13] KIM W S,LEE S S,LEE C M,et al.Hepatitis C and not Hepatitis B virus is a risk factor for anti-tuberculosis drug induced liver injury[J].BMC Infect Dis,2016,16[2021-10-09].https://pubmed.ncbi.nlm.nih.gov/26833347.DOI:10.1186/s12879-016-1344-2.
[14] 李凌未,马凌飞,李胜前.412例抗结核药物导致肝损害的临床评价分析[J].药物流行病学杂志,2016,25(12):773-776.
LI L W,MA L F,LI S Q.Retrospective clinical evaluation of anti-tuberculosis drug induced liver injury[J].J Pharmacoepidemiol,2016,25(12):773-776.
[1] 刘晶芝, 胡燕燕, 张学伟, 阿依努尔. 新疆阿勒泰农牧区哈萨克族小学生贫血调查[J]. 预防医学, 2023, 35(9): 807-810.
[2] 朱思懿, 洪航, 边学燕, 许国章. 慢性肾脏病流行病学研究进展[J]. 预防医学, 2023, 35(9): 770-773.
[3] 俞素芬, 蒋青林, 戴杰. 2012—2021年吴兴区新报告HIV/AIDS病例晚发现及影响因素分析[J]. 预防医学, 2023, 35(9): 796-799.
[4] 王远航, 胡洁, 葛锐, 富小飞, 亓云鹏. 嘉兴市结核分枝杆菌耐药情况分析[J]. 预防医学, 2023, 35(8): 705-709.
[5] 方柯红, 朱冰, 黄利明, 张旭慧, 刘辉. 杭州市成年居民营养健康知识调查[J]. 预防医学, 2023, 35(8): 710-713.
[6] 周星缘, 洪航, 方挺, 许国章. 肺炎流行病学研究进展[J]. 预防医学, 2023, 35(8): 682-686.
[7] 柏旭, 苏洁, 李凤, 徐倩, 沈源, 肖凌凤. 我国成人糖尿病视网膜病变影响因素的Meta分析[J]. 预防医学, 2023, 35(7): 595-601.
[8] 王梦琴, 柴荟琳, 郭宇燕, 任敬娟, 梁瑞峰. 山西省农村居民高血压防治知识、态度、行为调查[J]. 预防医学, 2023, 35(7): 563-569.
[9] 黎燕, 雷梦婷, 王燧, 殷淑娇, 章存瑞, 李清春. 一起涉及多所学校的肺结核聚集性疫情调查[J]. 预防医学, 2023, 35(7): 607-610.
[10] 彭晶, 傅文婷, 杨秀琳. 甘南藏族自治州老年人群健康素养调查[J]. 预防医学, 2023, 35(6): 546-550.
[11] 常倩, 王维丹, 钱建军, 胡华锋. 绍兴市严重精神障碍患者健康体检的影响因素分析[J]. 预防医学, 2023, 35(6): 491-495.
[12] 姜海波, 洪航, 周健, 李继革, 史宏博, 谭诗文, 褚堃, 张丹丹. 宁波市HIV/AIDS病例新型毒品使用情况调查[J]. 预防医学, 2023, 35(6): 470-474.
[13] 杨冰声, 曹承建. 杭州市美沙酮维持治疗患者脱失的影响因素分析[J]. 预防医学, 2023, 35(6): 522-525.
[14] 曾龙武, 唐晓鸿, 张素霞, 刘强, 梁朝聪, 唐漫漫. 结直肠癌化疗患者照护人疾病不确定感影响因素分析[J]. 预防医学, 2023, 35(5): 444-447.
[15] 王倩倩, 章涛, 李傅冬, 林君芬, 何凡, 俞敏, 曹亦菲. 老年人群白内障的影响因素分析[J]. 预防医学, 2023, 35(4): 311-315.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed