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항결핵 약제 유발 간독성과 혈중 항결핵 약제 농도의 상관관계 : Drug induced hepatotoxicity of anti-tuberculosis drug and their serum levels
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- Authors
- Advisor
- 이재호
- Major
- 의학과 내과학전공
- Issue Date
- 2011-02
- Publisher
- 서울대학교 대학원
- Keywords
- 결핵 ; 간독성 ; 약제모니터링 ; Backgrounds: Hepatotoxicity is one of the most common adverse reaction of anti-tuberculosis(TB) treatment. Relatively little is known about hepatotoxicity and their serum levels of anti-TB drugs. Objective: To investigate the incidence of drug-induced hepatotoxicity (DIH) caused by anti-TB drugs and to identify the association of DIH and serum anti-tuberculosis drug concentrations. Methods: Serum levels of isoniazid (INH) ; rifampicin (RMP) ; ethambutol (EMB) ; pyrazinamide (PZA) were analysed by blood sample 2 hours after drug ingestion in patients on anti-TB treatment. DIH was investigated retrospectively and defined when liver enzyme exceed three times upper limit of normal. We compared serum drug level and other clinical factors between hepatotoxicity group and no-hepatotoxicity group. Patients with HIV co-infection ; acute viral hepatitis ; chronic liver disease ; malabsorption were excluded. Results: Between June 2006 and Feb 2010 ; 195 patients were included in the analysis. The median age of 195 patients(men 60%) was 46 yrs(range 16-92). Hepatotoxicity occurred in 19(9.7%) patients and their mean AST ; ALT was 245 ; 244. Among 19 patients ; PZA related and INH or RMP related hepatotoxicity was estimated in 9 and 8 patients respectively. However ; serum levels of four anti-TB drugs did not differ statistically between hepatotoxicity and no-hepatotoxicity group. Age ; sex ; past history of TB ; body mass index(BMI) also did not show statistical difference. Conclusion: There were relatively small number of patients whose drug level exceeds reference range and serum drug level did not show relevance to DIH.
- Description
- 학위논문 (석사)-- 서울대학교 대학원 : 의학과 내과학전공, 2011.2. 이재호.
- Language
- kor
- URI
- https://hdl.handle.net/10371/158312
http://dcollection.snu.ac.kr:80/jsp/common/DcLoOrgPer.jsp?sItemId=000000030457
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