肝肾功能及血常规参数在肺结核患者药物治疗过程中的变化及临床意义

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Abstract

Objective To analyze the changes of liver and kidney function, blood routine and adverse reactions in patients with active pulmonary tuberculosis before and after anti-tuberculosis drug treatment, and to find out the monitoring indicators that can be used for the efficacy of anti-tuberculosis treatment. Methods A total of 55 patients with active pulmonary tuberculosis who received anti-tuberculosis drug treatment in Loudi Central Hospital from January 2019 to January 2020 were selected as case group, and 55 healthy people in the same period were selected as control group.The related clinical data and test results were collected, and the adverse reactions during anti-tuberculosis drug treatment in the case group were recorded. The dynamic changes of blood routine and liver and kidney function before and after treatment in the case group and the control group were detected. Results Before treatment, there were no significant differences in white blood cell count (WBC) and platelet/lymphocyte ratio (PLR) between case group and control group (P＞0.05). The red blood cell distribution width (RDW) and neutrophil/lymphocyte ratio (NLR) in the case group were higher than those in the control group, and the differences were statistically significant (P＜0.05). The incidence of liver function damage was the highest in the case group, among which the incidence of alanine aminotransferase (ALT)and/or aspartate aminotransferase (AST) increased was 18.18%, the incidence of bilirubin (TBil) increased was 10.91%, followed by gastrointestinal reaction (14.55%).The incidence of elevated uric acid (UA), allergic reaction, leukopenia and thrombocytopenia were 9.09% ,3.64%, 7.27% and 3.64%, respectively. There were no significant differences in WBC, PLR and TBil before and after treatment in the case group (P＞0.05). RDW and NLR were lower after treatment than before treatment, ALT and/or AST and UA were higher than before treatment, and the differences were statistically significant (P＜0.05). Conclusion Patients undergoing antituberculosis therapy need regular evaluation of blood routine and liver and kidney function, close attention to adverse reactions, and timely and effective intervention. RDW, NLR and other parameters have important clinical application value in monitoring the therapeutic effect of active pulmonary tuberculosis.

Key words： Tuberculosis Medication Adverse reactions Therapeutic effect

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