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我科自1979年以来,曾遇二例肺结核应用利福平、异菸肼联合治疗过程中,造成严重肝功能损害,其中一例合并肝昏迷,经抢救无效死亡。现报告如下: 例一马××、女、回族、24岁。1979年3月29日因发现急性粟粒型结核住我科。同年11月因反复发作头痛、伴恶心、呕吐一个月,于1979年12月30日再次住院。入院后脑脊液检查符合结核性脑膜炎改变。经给以INH 300mg/日静点、PAS8gm/日静点、链霉素0.75gm/日,同时配合脱水治疗,疗效不满意,肝功能检查正常,1980年1月10日加用利福平450 mg/日、乙胺丁醇1gm/日后一直有恶心、呕吐。3月10日出现皮肤、巩膜黄染,并逐渐加深。有烦燥、谵妄,当即停用利福平,继而昏迷。经传染科会诊,疑急性肝坏死所致肝昏迷,
Since 1979, our department has encountered two cases of tuberculosis application of rifampicin, isoniazid combination therapy, resulting in serious liver damage, one case of co-hepatic coma, after the rescue died. Now report as follows: A case of a horse × ×, female, Hui, 24 years old. March 29, 1979 due to the discovery of acute miliary tuberculosis live in our department. The same year in November due to recurrent headache, nausea, vomiting for a month, on December 30, 1979 again hospitalized. Cerebrospinal fluid examination after admission conforms to tuberculous meningitis. After giving INH 300mg / day static point, PAS8gm / day static point, streptomycin 0.75gm / day, combined with dehydration, the effect is not satisfied, the liver function test was normal, January 10, 1980 plus rifampicin 450 mg / day, ethambutol 1gm / has been nauseous and vomiting. March 10 skin, scleral yellow dye, and gradually deepened. Irritable, delirium, immediate withdrawal of rifampicin, and then coma. The infectious disease consultation, suspected liver necrosis caused by hepatic coma,