頁籤選單縮合
題 名 | 剖析抗結核藥致肝毒性與重新投藥=Reintroduction of Regimens after Hepatoxicity Caused by Antituberculosis Therapy |
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作 者 | 劉錦鳳; 王靖菁; 蕭惠娟; 曹惠良; 廖芬芬; | 書刊名 | 藥學雜誌 |
卷 期 | 29:1=114 2013.03[民102.03] |
頁 次 | 頁50-55 |
分類號 | 418.2219 |
關鍵詞 | 抗結核藥重新投予; 抗結核藥致肝毒性; Antituberculosis drugs reintroduction; |
語 文 | 中文(Chinese) |
中文摘要 | 結核病的治療需使用數種抗結核藥,一線藥中 isoniazid (H)、rifampin (R)、和 pyrazinamide (Z),皆具有不同程度的肝毒性。病人服藥後發生肝毒性的試藥方式,尚無統一的標準,本研究回溯某醫學中心自94年至99年間,通報抗結核藥品引起肝毒性的案例,我們觀察肝功能指數的變化,並分析醫師重新投藥的策略。結果符合條件共26位,試藥順序以先給H再給R為最多有15人 (60%),其次是先給R再給H有5人 (20%),此過程有5人 (25%)再次發生肝毒性;另有9位當重新加回Z時,成功有5位 (55%),分析4例 (45%) 失敗的原因皆為肝指數異常,在探究重試Z藥失敗比例高,因此我們認為服用 HRZ 發生肝毒性較嚴重者,不建議再重試時加回Z。 |
英文摘要 | First-line anti-tuberculosis (anti-TB) drugs contain isoniazid (H), rifampicin (R), and pyrazinamide (Z). However H, R, Z each is accompanied by different degrees of hepatotoxicity. The reintroduction of anti-TB drugs to patients who have developed drug-induced hepatitis (DIH) is controversial. This is a retrospective study on patients who are diagnosed with anti-TB DIH, starting from 2005 to 2010. We checked the patients’ liver functions and then analyzed the strategy-result of reintroduction regimens.26 cases with anti-TB DIH were assessed as eligible for this study, the process of the reintroduction goes as follows: up to 15 (60%) of the patients restarted with H and then R, while only 20% (5) of the patients used R first and then took H. However, DIH recurred 5 among of them. Also, we found 9 of the patients who had rechallenged with Z, 5 patients (55%) successed after the reintroduction. Lastly, our analysis shows that the treatment of the other 4 patients (45%) failed because of the recurrence of DIH. The recurrence rate among those who were rechallenged with Z, on the other hand, was high. Therefore we suggest that the patients who have serious liver toxicity after taking HRZ should not use Z-adding when rechallenged. |
本系統中英文摘要資訊取自各篇刊載內容。