Abstract:
Objective：To investigate the risk factors and treatment methods of liver dysfunction due to taking anti-tuberculosis for the first time in children with tuberculosis.
Methods：In the children who was admitted to Shenyang Chest Hospital from March of 2008 to May of 2014 and received first-time treatment for tuberculosis(TB) with isoniazid,rifampicin and pyrazinamide,36 developed liver damage within 2 weeks to 3 months of treatment.Fourteen children(38.89%) had the risk factors,among whom 12 children took other drugs at the same time,one had mild malnutrition and one was hepatitis C Virus carrier.The clinical data of the 36 cases were analyzed to summarize the clinical features,treatment protocol and prognosis.
Results：All the 36 TB children developed liver damage of different degrees after first-time treatment(23 were acute hepatitis type,5 acute cholestasis type,8 mixed type).After the treatment protocol was adjusted and the drugs that might cause liver damage were stopped(azithromycin,erythromycin,analgesics and antipyretics,cephalosporin,etc.),the 36 children completed the treatment course and were cured.
Conclusion：Rifampicin and pyrazinamide are the main drugs that induce liver damage in children receiving treatment for the first time.It may increase the risk of liver damage to use other drugs or if the children have malnutrition or have been with liver diseases before.The drugs should be stopped and give liver-protection treatment for different degrees of damage.Isoniazid,rifapentine,ethambutol and streptomycin can be used in the individualized anti-TB treatment to relieve the patients′ pain and shorten treatment course,in order to cure the disease.

Key words: Tuberculosis, Liver damage, Rifampicin, Pyrazinamide, Child