抗結核病藥物併用其他疾病藥物產生肝毒性之研究

目的：在於探討病人服用抗結核藥物與併服藥物發生肝毒性的關聯性。方法：採回溯性病歷回顧自2008年1月1日至2010年12月31日為期三年，於南部某區域教學醫院門診或住院被首次診斷感染結核菌並接受抗結核藥物治療之病人，記錄其基本資料、疾病史、肝功能生化檢驗值和用藥紀錄等各項資料，並分析是否發生肝毒性與其共病和共病併服之藥物具有關聯性。結果：符合納入條件的病人共97人，肝毒性發生率為14.4%（14人），與發生肝毒性具統計意義的共病有高血壓（p = 0.045）、冠心病（p = 0.007），共病併服之藥物有amlodipine（p = 0.035）。結論：接受抗結核藥物治療之病人患有高血壓、冠心病時和有併服amlodipine時，須特別注意其肝毒性的發生。

關鍵字

肺結核；多重用藥；肝毒性

並列摘要

Objective: To investigate the occurance and correlation of antituberculois drug-induced hepatotoxicity in patients who are taking antituberculosis drugs and other medications for their comorbidity. Methods: Both outpatients and inpatients who were first diagnosed and treated for their TB infection in a south regional teaching hospital in Taiwan, from January 1, 2008 to December 31, 2010 were used for this retrospective chart review study. The patient’s basic information, medical history, liver function test values and their three years' medication records were recorded and critically analyzed. Occurrence of hepatotoxicity in patients taking antituberculosis drugs with or without additional medications needed for treating their comorbidity was statistically analyzed and compared to see whether or not there are any significant differences. Results: A total of 97 patients who met the inclusion criteria were included in this study. Among them, the hepatotoxicity rate was 14.4% (14 person). The occurrence of antitubuculosis drug-induced hepatotoxicity was significantly correlated with those patients who have hypertension (p = 0.045), coronary heart disease (p = 0.007), and specifically with those who have taking amlodipine (p = 0.035) for their comorbidities. Conclusion: This retrospective study revealized that we must pay special attention to the possible occurrence of hepatotoxicity in the pharmacotherapy for a tuberculosis patient who has either hyperstension or coronary heart condition that requires heart medications such as amlodipine.

並列關鍵字

Tuberculosis ； Polypharmacy ； Hepatotoxicity

國際替代計量

抗結核病藥物併用其他疾病藥物產生肝毒性之研究

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