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酒精消费作为抗结核药物诱导肝损伤的危险因素:系统性审查和元分析
Fan Zhang1, Fuzhen Zhang1, Mingyang Qin1
1Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, PR China; Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, Beijing, 101149, PR China.
在结核患者中,酒精消费增加了抗结核药物诱导的肝损伤 (ATDILI) 的风险. 在抗结核治疗期间,减少酒精摄入量至关重要,以减轻肝损伤风险.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 药理学 药理学是指药理学的学科.
- 传染性疾病 传染性疾病
背景情况:
- 结核病 (TB) 是一个重要的全球性传染病.
- 药物诱导性肝损伤 (DILI) 来自抗结核药物 (ATTB) 损害了治疗的坚持.
- 酒精消费对ATTB诱导的肝损伤 (ATDILI) 的影响仍在争论中.
研究的目的:
- 系统地评估酒精消费与ATDILI之间的关联.
- 量化使用酒精的结核病患者ATDILI的风险.
主要方法:
- 在PubMed,Web of Science,Scopus和Embase数据库中进行了全面的文献搜索,截至2023年4月.
- 对53项选定的研究进行了元分析,分析了来自1152项最初文献评论的数据.
- 统计分析使用了几率比率 (OR) 与95%信心区间 (CI);使用Begg和Egger测试评估了出版偏差.
主要成果:
- 发现酒精消费显著增加了ATDILI的风险 (OR:1.55;95%CI:1.19-2.04).
- 在酒精和非酒精子组中观察到增加的ATDILI风险.
- 没有检测到出版偏差,表明 robust 发现.
结论:
- 在接受治疗的结核病患者中,酒精消费被确定为ATDILI的确切危险因素.
- 应建议接受ATTB治疗的患者减少或避免饮酒.
- 建议进行进一步的研究,以充分阐明酒精摄入量与ATDILI之间的复杂关系.
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