Analysis of influencing factors on drug-induced liver injury induced by anti-tuberculosis therapy in patients with newly treated pulmonary tuberculosis combined with hepatitis B virus infection
Objective To explore the influencing factors of drug-induced liver injury induced by anti-tuberculosis therapy in patients with newly treated pulmonary tuberculosis combined with hepatitis B virus(HBV)infection.Methods The clinical data of 318 patients with newly treated pulmonary tuberculosis combined with HBV infection admitted to the First Hospital of Changsha City from December 2018 to January 2023 were retrospectively analyzed.According to whether drug-induced liver injury was induced by anti-tuberculosis therapy in the selected patients,they were divided into the liver injury group(51 cases)and the non liver injury group(267 cases).The clinical data of two groups were compared,and the risk factors of drug-induced liver injury induced by anti-tuberculosis therapy in patients with newly treated pulmonary tuberculosis combined with HBV infection were analyzed by multivariate Logistic regression analysis.Results The proportion of patients with cardiovascular diseases,endocrine diseases,history of other viral liver diseases,no use of liver protection drugs,malnutrition,and anti-tuberculosis treatment regimen containing pyrazinamide in the liver injury group was 49.02％,41.18％,7.84％,68.63％,39.22％,and 78.43％,respectively,and all were higher than 34.46％,27.34％,0.00％,49.81％,20.60％,and 26.59％in the non liver injury group.The levels of serum prealbumin(PA)and cholinesterase(ChE)in the liver injury group were lower than those in the non liver injury group;The levels of serum γ-glutamyltransferase(GGT)and the viral load of hepatitis B virus deoxyribonucleic acid(HBV-DNA)in the liver injury group were higher than those in the non liver injury group(P＜0.05).The results of multivariate Logistic regression analysis showed that endocrine diseases,history of other viral liver diseases,no use of liver protection drugs,malnutrition,anti-tuberculosis treatment regimen containing pyrazinamide,low levels of serum PA,and low levels of serum ChE,high levels of GGT were the independent risk factors for drug-induced liver injury induced by anti-tuberculosis treatment in patients with newly treated pulmonary tuberculosis combined with HBV infection(OR=2.782,2.125,2.683,3.364,1.758,1.885,2.408,2.901,P＜0.05).Conclusion Endocrine diseases,history of other viral liver diseases,no use of liver protection drugs,malnutrition,anti-tuberculosis treament regimen containing pyrazinamide,low levels of serum PA,low levels of serum ChE,and high levels of serum GGT are independent risk factors for drug-induced liver injury induced by anti-tuberculosis treatment in patients with newly treated pulmonary tuberculosis combined with HBV infection.Based on this,targeted treatment or intervention can be given to high-risk patients in clinical practice to prevent or reduce the occurrence of drug-induced liver injury.
pulmonary tuberculosishepatitis B virusinitial treatmentdrug-induced liver injuryinfluencing factor
万方数据
维普
