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目的观察抗结核药4种固定剂量复合制剂(FDC)引起药物性肝损伤(DILI),分析不良反应发生相关因素,为更好地开展结核病控制工作提供参考。方法对抗结核药4种FDC引起DILI1例患者进行分析。结果经护肝治疗1周后,肝损伤加重,谷丙转氨酶(ALT)>10ULN,谷草转氨酶(AST)>2ULN,ALT/AST>5,因目前国内外没有统一的抗结核药所致DILI诊断标准,排除其他致肝损伤因素,依据综合肝损伤国际检查标准和药物性肝病检测指标、抗结核药所致DILI诊断与处理专家建议,诊断为肝细胞性重度药物肝损伤。结论 FDC抗结核治疗过程中应提高结防医生和患者对抗结核药不良反应的认识、严格规范诊疗、提高抗结核治疗治愈率。
Objective To observe the drug-induced liver injury (DILI) caused by 4 fixed-dose combination (FDC) anti-TB drugs and to analyze the related factors of adverse reactions, so as to provide a reference for better TB control. Methods One case of DILI caused by four kinds of FDC caused by anti-tuberculosis drugs was analyzed. Results After 1 week of treatment, the liver injury was aggravated. The ALT> 10ULN, AST> 2ULN and ALT / AST> 5 were diagnosed by DILI because of the lack of uniform anti-TB drugs at home and abroad Standards, excluding other factors that cause liver damage, based on the international inspection of liver injury and drug-induced liver disease indicators, DILI diagnosis and treatment of anti-TB drugs experts suggest that the diagnosis of hepatocellular severe drug-induced liver injury. Conclusion During the FDC anti-TB treatment, we should increase the awareness of physicians and patients on anti-tuberculosis adverse reactions, strictly regulate diagnosis and treatment, and improve the cure rate of anti-TB treatment.