Retrospective Analysis Of Anti-tuberculosis Drug-induced Hepatotoxicity In Children

Objective:Through the retrospective analysis of the anti-tuberculosis drug-induced hepatotoxicity(ATDH),it can attribute to understand the clinical characteristics and the changes of biochemical indexes,to guide the prevention,treatment and follow-up of the ATDH,and to avoid the occurrence of the serious ATDH.Methods: In the Children's Hospital affiliated to Chongqing Medical University,Patients with newly diagnosed tuberculosis and ATDH from 2014 to 2017 were enrolled,and retrospective analysis was carried out.Results: The incidence of ATDH in children was about 5.3%(45 / 847).The main type of liver injury in ATDH was hepatocyte type,followed by mixed type and cholestasis type.The occurrence time of the ATDH was mainly about 5-25 days.Pyrazinamide is the main drug caused the ATDH,followed by pyrazinamide and rifampicin combined drug-induced liver injury.The level of total bile acid was higher in the patients with ATDH than that in the control group(P<0.05).The decrease of alanine aminotransferase was 50% in most patients within 3-8 days after anti-tuberculosis drug withdrawal.In the group with recovery time longer than 8 days,the proportion of female was higher than that of male(P<0.05).At the same time,there was a positive correlation between age and recovery time of liver function(P<0.05).Conclusion:The main type of liver injury in ATDH was hepatocyte type,followed by mixed type and cholestasis type.The occurrence time of the ATDH was mainly about 5-25 days.Pyrazinamide is the main drug caused the ATDH,followed by pyrazinamide and rifampicin combined drug-induced liver injury.Total bile acids may be a predictor of the ATDH.The decrease of alanine aminotransferase was 50% in most patients within 3-8 days after anti-tuberculosis drug withdrawal.Women,and older patients with the ATDH may have a longer recovery time.