抗结核药物诱导的肝损伤:当前的理解和新兴方向
Shubham Prasad1, Himanshu Narang1, Saurabh Kedia1
1Department of Gastroenterology and Human Nutrition All India Institute of Medical Sciences New Delhi India.
JGH open : an open access journal of gastroenterology and hepatology
|January 21, 2026
概括
药物诱导性肝损伤 (DILI) 来自抗结核治疗 (ATT) 是不可预测的,也是治疗停止的主要原因. 早期发现和迅速管理ATT-DILI对于更好的患者结果和降低死亡率至关重要.
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:
- 药物诱导性肝损伤 (DILI) 是抗结核治疗 (ATT) 的显著不良影响,导致治疗停止.
- 在东南亚,ATT-DILI是药物诱导的急性肝衰竭 (ALF) 的主要原因,死亡率高.
研究的目的:
- 审查ATT诱导的DILI的频谱,风险因素,诊断和管理.
- 强调早期检测和监测的重要性,以改善预后.
主要方法:
- 关于 ATT-DILI 的文献综述.
- 讨论风险因素,诊断挑战和管理策略.
- 在DILI之后探索ATT的重新引入协议.
主要成果:
- ATT-DILI频谱范围从无症状的转氨酶升高到ALF,死亡率高达70%.
- 风险因素包括年龄增长,女性性别,遗传学,营养不良,肝病和病毒感染.
- 诊断是排除的;轻微的转氨酶升高可能是肝脏适应. 早期检测和药物戒断是关键.
结论:
- 迅速管理ATT-DILI,包括药物戒断和仔细的重新引入,改善了结果.
- 需要进一步的研究来确定早期ATT-DILI诊断的生物标志物.
- 尽管存在风险,但ATT的好处往往大于它们,需要个性化管理.
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