范文穗,郑健,杨根东,简炎林,谭卫国,刘国辉
FAN Wensui,ZHENG Jian,YANG Gendong,JIAN Yanlin,TAN Weiguo,LIU Guohui

• 1:深圳市第三人民医院
• 2:深圳市慢病院

摘要(Abstract)：

目的分析耐多药肺结核治疗中抗结核药物出现的不良反应程度和首发时间,并寻找应对措施。方法通过每月电话访问和门诊复诊收集77例耐多药肺结核患者病例的回顾性数据,检查其肝功能,肾功能,尿酸水平及血液。结果消化系统损害发生率为72.7%,皮疹发生率为11.7%,高尿酸血症为18.2%,血液系统损害发生率18.2%,泌尿系统损害为24.7%,神经系统损害发生率为23.4%。因药物导致肝衰竭的有3例;药物导致肾功能衰竭的有2例;药物导致精神分裂的有1例。不良反应首发时间大多发生在化疗开始3个月内。结论二线抗结核药不良反应中肝损害发生率最高,部分患者出现严重药物性肝炎住院;肾损害和中枢神经系统的损害也应警惕。药学干预可有效改善患者用药依从性,提高患者对疾病的认识,从而减少耐药的产生增加耐多药肺结核的治愈率。
OBJECTIVE Through analysis of the starting time and degree of the adverse reaction of the antituberculosis drugs in multi-drug-resistant tuberculosis treatment,to find the corresponding coping measures. METHODS The followed-up data of 77 patients with multi-drug resistant antituberculosis were collected through correspondence and outpatient department visits monthly,and their liver functions,kidney functions,uric acid level and blood were examined. RESULTS The incidence of digestive damage was72. 7%; the incidence of getting skin rash was 11. 7%; the incidence of hyperuricemia was 18. 2%; the incidence of getting blood system damage was 18. 2%; the incidence of damage to the urinary system was 24. 7%. The incidence of getting damage to the nervous system was 23. 4%. 3 patients had liver failure,2 patients had kidney failure and 1 patient had schizophrenia after using the drugs.Most of the adverse reaction had been found occurred in the first 3 months after they were given chemotherapy. CONCLUSION The adverse reactions of the second line anti-tuberculosis drugs mostly appear in the damage of liver. Some patients would have severe druginduced hepatitis; and the damage to the kidney and central nervous system should also be aware of. Pharmaceutical intervention in the treatment can affectively improve the treatment compliance of the patients,and can help them to have a better understanding of the disease,so as to reduce the chance of getting drug resistance and increase chances of getting cured.

关键词(KeyWords)： 耐多药结核;抗结核药;不良反应;药学干预
multi-drug resistant tuberculeosis;antituberculosis drugs;adverse reaction;pharmaceutical intervention

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 范文穗,郑健,杨根东,简炎林,谭卫国,刘国辉
FAN Wensui,ZHENG Jian,YANG Gendong,JIAN Yanlin,TAN Weiguo,LIU Guohui

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