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目的:建立测定抗结核药血药浓度的方法,并观察其临床疗效与安全性。方法:选择我院2007年8月-2010年12月164例结核病住院患者,采用高效液相色谱(HPLC)法分别测定患者连续服药1个月后异烟肼、利福平、吡嗪酰胺的血药浓度,分析不同血药浓度的临床疗效及肝损害情况。结果:异烟肼、利福平、吡嗪酰胺的血药浓度高于正常浓度范围者分别占9.1%、12.8%、24.4%,低于正常浓度范围者分别占54.3%、9.8%、6.7%。临床疗效以完全改善和明显改善者居多,占92.1%。药物性肝损害多发生在用药后1个月内,以老年人多见。49例肝损害患者中血药浓度高于正常者占73.5%。结论:HPLC法可用于抗结核药血药浓度监测,其结果是临床调整用药剂量的重要依据,对结核病患者合理用药具有重要意义。
Objective: To establish a method of determining the concentration of anti-TB drug in blood and observe its clinical efficacy and safety. Methods: One hundred and sixty-four inpatients with tuberculosis in our hospital from August 2007 to December 2010 were enrolled in this study. High-performance liquid chromatography (HPLC) was used to determine the effect of isoniazid, rifampin, pyrazinamide Blood concentration, analysis of different blood concentrations of clinical efficacy and liver damage. Results: The plasma concentrations of isoniazid, rifampicin and pyrazinamide accounted for 9.1%, 12.8% and 24.4%, respectively, which were 54.3%, 9.8% and 6.7% lower than the normal range, respectively . Clinical efficacy to improve and significantly improve the majority, accounting for 92.1%. Drug-induced liver damage occurred more than 1 month after treatment, more common in the elderly. 49 cases of liver damage in patients with plasma concentrations higher than the normal accounted for 73.5%. Conclusion: HPLC method can be used to monitor the blood concentration of antituberculosis drugs. The result is an important basis for adjusting the dose of the drug for clinical use. It is of great significance to rational use of drugs in patients with tuberculosis.