結核症の肝障害に関する臨床的並びに実験的研究

―抗結核剤による肝障害および自律神経因子を中心として―

抄録

Influences of extent of pulmonary tuberculous lesion (NTA), period of treatment and anti-tuberculous drugs on liver functions were investigated clinically and experimentally.
16.3% of 420 patients with pulm. tbc. revealed disturbance of liver functions, of which colloidal reaction showed marked abnormality.
Of 20 cases with recently developed pulm, tbc., some patients already had decrease of liver functions.
Administration of anti-tuberculous drugs resulted in further elevation of the transamin ase of these patients, although the value was within normal limits.
Pathological examination by liver biopsy specimen correlated well with the results of function tests.
Toxicity of anti-tuberculous drugs to the liver was studied by animal experiment using rabbits. Liver function tests and pathological examination revealed that the toxicity of TH or PZA was greater than PAS in 5 times the amount clinically used.
Effects of autonomic nervous aystem on liver functions were observed : the rabbits was divided in two groups, following cutting off Rt vagus or both cervical sympathetic nerve and Rt splanchnic nerve respectively. Liver functions were examined on these groups before and after administration of anti-tuberculous drugs. The first group revealed increase of B. S. P. value, which was markedly elevated after admin istration of the chemotherapeutic drugs. No derangement of liver functions were observed in the other group.
From clinical and experimental observation, autonomic nervous system was suggested to take part in decrease of liver functions by tuberculous infection.