Clinical And Experimental Of Ntitubercular Agent-induced Hepatotoxicity In Children

PART ONE CLINICAL FEATURES OF TITUBERCULARAGENT-INDUCED HEPATOTOXICITY IN CHILDRENObjective: To study the influence factors, clinical features, and controlmeasures of antitubercular agent-induced hepatotoxicity in children.Methods: The clinical data of194patients with hepatotoxicity causedby anti-tuberculosis agent，which in1691patients with various types oftuberculosis as the research object, were analyzed retrospectively.Results: The incidence of agent-induced hepatotoxicity is8.8％.Thepatients aged≤1took the lead，with61cases (31.44%);53.54%ofagent-induce hepatotoxicity occurred in6-10days after medication.Therewere63.31%patients with symptoms,and anorexia,nausea, vomiting,jaundice，bellyache，bloating and rash were the most frequently observedsymptoms.Live disfunction in patients with clinical manifestation wassignificantly higher than those with no clinical manifestation（P<0.05）.There was no statistics difference in live disfunction betweenpatients with multi-system damage and single damage（P>0.05）.As forthose patients whose live disfunction would be high, the difference in the use time of liver protectant with no statistically significant（P>0.05）.Conclusion: The incidence of antitubercular agent-inducedhepatotoxicity was higher in the infancy. The non-specificity in clinicalmanifestation of antitubercular agent-induced hepatotoxicity inchildren,and the degree of hepatotoxicity was more serious in patients withclinical manifestation. The patients with the hematogenous disseminatedtuberculosis may be easy to develop to hepatotoxicity. No correlation theuse time of liver protectant and degree of hepatotoxicity. PART TWO STUDY ON THE HEPATOXICITY INDUCED BYRIFAMPICIN IN MOUSE PUPSObjective: To investigate dose-effect and time-effect relationships onrifampicin-induced hepatoxicity. and provide the basis for the clinical.Methods:2-3weeks mouse pups were divided randomly into4groups: low-dose group（RIF50mg/kg·d）,middle-dose group（RIF100mg/kg·d）, high-dose group（RIF150mg/kg·d）and the control group（NS）,with6mouse pups in each group.Mouse pups in each group weregiven intragastric infusion with a daily dose of0,50mg/kgRIF,100mg/kgRIF and100mg/kgRIF for10,20, and30days, respectively.Then6rats in each group were killed to collect blood samples and the levels ofALT， AST， ALP,TB and TBA in the blood-serums weremeasured．Pathohistology an-alysis of the liver was also performed.Results: As compared with those in control group, the difference ofthe pathological changes of liver tissue and liver function in experimentalgroup with no statistically significant. Conclusion: RIF cause no damage of the liver in mouse pups with adose from50to150mg/kg.