结核病治疗过程中乙型肝炎病毒感染能预测肝毒性吗?制定一个初步的预测规律

被引：5

作者：

L.de Castro

P.E.A.A.do Brasll

T.P.Monteiro

V.C.Rolla

韩喜琴

刘宇红

机构：

[1] InstitutodePesquisaClinicaEvandroChagas,FundaoOswaldoCruz,RiodeJaneiro,RiodeJaneiro,Brazil

来源：

国际结核病与肺部疾病杂志 | 2010年 / 5卷 / 03期

关键词：

结核; 乙型肝炎病毒; 抗结核药物; 药物毒性; 列线图; HIV;

D O I：

暂无

中图分类号：

R512.62 []; R52 [结核病];

学科分类号：

100401 ; 1002 ; 100201 ;

摘要：

背景:结核病治疗过程中肝毒性的出现常常导致抗结核治疗的中断,或调整为较弱的治疗方案。目的:评估乙型肝炎病毒(HBV)感染者和未感染者在接受抗结核治疗过程中出现肝毒性的风险,从而制定出一套临床可遵循的预测规律。设计:采用前瞻性观察随访的研究方法。对接受抗结核治疗的154例患者的临床资料进行分析,采用粗风险比率估算并应用Cox比例风险模型分析。结果:平均随访日为187 d,粗风险比率显示种族、人类免疫缺陷病毒感染(HIV)、多个性伴侣、高效联合抗病毒治疗以及结核病的临床类型可摘要能是出现肝毒性的预测因子。虽然无统计学意义,但HBV感染和其他性传播疾病仍显示为相当大的相对危险度。Cox风险比例模型显示以下为出现肝毒性的高危因素:白种人、多个性伴侣、基础谷丙转氨酶升高以及结核病的临床类型。虽然缺乏精确的证据,但通过HBV表面抗原检测证实为活动性乙型肝炎的患者,仍预示可能出现肝毒性。结论:通过以上信息,我们可以根据分值绘制出列线图来估算每一个患者的生存概率和事件发生的中位时间。

引用

页码：101 / 109

页数：9

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