Study On The Correlation Between Allergy Constitution And Adverse Reactions Of Anti-tuberculosis Drugs

Purpose:By observing the occurrence of adverse drug reactions(ADRs)after first-line anti-tuberculosis drug treatment in tuberculosis patients in the positive group and the negative group of allergen detection,the application value of in vitro allergen detection in the evaluation of anti-tuberculosis drug chemotherapy ADRs was discussed,so as to optimize the anti-tuberculosis treatment for tuberculosis patients.Methods:Collection of zunyi medical college affiliated hospital in 2017-September 1to December 31,2018,application of first-line anti-tb drugs(HRZE)for the treatment of118 cases of hospitalized patients with tuberculosis(TB),blood line detect allergen and serum total IgE,divided into positive group(allergen test positive,n = 73)and negative groups(allergen test negative,n = 45),observe the basic clinical data of two groups of patients(gender,age)and outpatient follow-up 2 months of ADRs incidence,occurrence time,clinical manifestations and severity.Results:? There were 73 patients in the positive group,46 males(63.01%)and 27females(36.99%),aged between 18 and 81(43.67±18.43)years old.There were 45 patients in the negative group,including 21 males(46.67%)and 24 females(53.33%),aged from 14 to 77(47.13±19.81).There was no significant difference in age and sex between the two groups(P > 0.05).? Anti-tuberculosis Drug induced Hepatotoxicity(ATDH):The incidence of ATDH in the positive group was 83.56%(61/73),and the time of ATDH in the anti-tuberculosis treatment was 3 to 60(15.64±11.69)days,including 57 cases(78.08%)with mild liver damage and 3 cases with moderate liver damage.(4.11%),severe liver damage in 1 case(1.37%),hepatocyte type in 27 cases(36.99%),cholestasis type in 17 cases(23.29%),mixed type in 10 cases(13.70%),and inability to type in 7 cases(9.59%);the incidence of negative group was 28.89%(13/45),and the time of occurrence was 13~56(27.31±10.80)days,all of which were mild liver damage,6 cases of hepatocyte type(13.33%),cholestasis type 5 cases(11.11%),mixed type 2 cases(4.44%).The incidence of ATDH and mild ATDH in the positive group was higher than that in the negative group(P<0.05).The time of ATDH in the positive group was earlier than that in the negative group(P<0.05).?Hyperuricemia:The incidence of hyperuricemia in the positive group was 49.32%(36/73),and the time of hyperuricemia after antituberculosis treatment was 3~58 days,with an average of 5 days(median);the incidence of the negative group was 75.56%(34/45),the occurrence time was 3~56 days,with an average of 6 days(median);the incidence of hyperuricemia in the negative group was higher than that in the positive group,the difference was statistically significant(P>0.05).There was no significant difference in the time of hyperuricemia(P>0.05).?Drug eruption: The incidence of drug eruption in the positive group was 34.25%(25/73),and the time of drug eruption after anti-tuberculosis treatment was 19 ~ 50(28.75±16.10)days,of which 23 cases(31.51%)were mild and 1 case(1.37%)were moderate.1 case(1.37%);the incidence of drug eruption in the negative group was11.11%(5/45),and the incidence time was 25~56(38.80±19.98)days,all of which were mild;the incidence of drug eruption in the positive group was higher than that in the negative group.The difference was statistically significant(P<0.05).There was no significant difference in the incidence,severity,and severity of drug eruption between the two groups(P>0.05).?Leukopenia: The incidence of leukopenia in the positive group was 8.22%(6/73),and the time to leukopenia after antituberculosis treatment was 3~25(18.00±12.17)days,mild reduction in 4 cases(5.48%),and moderate reduction in 2 cases(2.74%);the incidence of negative group was 6.67%(3/45),and the incidence time was 3 ~ 6(4.33±2.08)days,all of which were mildly reduced;the incidence of leukopenia,the time of occurrence and the mild to moderate severity of the two groups The difference was not statistically significant(P>0.05).?Gastrointestinal reaction: The incidence of gastrointestinal reactions in the positive group was 12.33%(9/73),the time of gastrointestinal reaction after anti-tuberculosis treatment was 15~42(27.56±15.40)days,and the incidence in the negative group was8.89%(4/45).The occurrence time was 10 ~ 46(27.50±19.74)days;there was nosignificant difference in the incidence and time of gastrointestinal reactions between the two groups(P>0.05).?Drug fever?Ptic neuritis?Mental disorders?Thrombocytopenia: 1 case in each positive group(1.37%),no one in the negative group.Conclusion: ?Allergic constitution is more likely to develop ATDH than normal physique patients after anti-tuberculosis chemotherapy and occurs earlier.?Allergic constitution is more prone to drug eruption than anti-tuberculosis chemotherapy in patients with normal constitution.?Serum allergen detection can be used to predict and evaluate the occurrence of ADRs in patients with tuberculosis.