摘要:
Objective To explore the deviation of plasma concentrations of isoniazid ( INH) and rifampicin ( RFP) between diabetes mellitus with pulmonary tuberculosis and pulmonary tuberculosis. Methods 30 diabetes mellitus patients complicated with pulmonary tuberculosis were taken as the observation group (the group A), and another 30 tuberculosis patients as control group ( the group B ) . It used high performance liquid chromatography ( HPLC) to measure the plasma concentrations of isoniazid ( INH) and rifampicin ( RFP) , and the results of the two groups were statistically analyzed by SPSS18. 0. Results 1. The plasma concentration of RFP in the group A de-creased significantly after treatment [(8.56 ±4.04)ug/mL and (14.91 ±4.99)ug/mL respectively, (t= -5.41, P=0. 00)]. 2. The plasma concentration of INH before and after treatment in the group A had no statistically signif-icant [(2. 89 ± 0. 78)ug/mL and (2. 92 ± 0. 71)ug/mL respectively] (t= -0. 18, P=0. 86). 3. The plasma con-centration of RFP decreased more significantly in the group A than in the group B [ ( 8. 56 ± 4. 04 ) ug/mL and (14. 24 ± 3. 48)ug/mL respectively] (t= -5. 77, P=0. 00). 4. The plasma concentration of INH in the group A and the group B had no statistical significance [(2. 89 ± 0. 78)ug/mL and (2. 96 ± 0. 96)ug/mL respectively] (t=-0. 29, P=0. 77). Conclusion The plasma concentration of INH in pulmonary tuberculosis patients is influenced by blood sugar but generally low. The plasma concentration of RFP may be influenced by blood sugar. The controlling of blood sugar may increase the plasma concentration of RFP. Therefore, plasma concentration should be monitored and drug dose should be adjusted appropriately.%目的 研究糖尿病合并肺结核患者体内异烟肼、利福平的血药浓度与单纯肺结核之间的差别,为临床用药提供理论支持.方法 随机选取糖尿病合并肺结核患者30例作为观察组(A组),单纯肺结核组30例为对照组(B组),采用高效液相色谱法(HPLC)测定患者体内异烟肼、利福平的血药浓度,两组间进行比较,采用SPSS18.0软件进行统计学分析.结果 (1)A组治疗前的血药浓度较治疗后显著降低[分别为(8.56±4.04)ug/mL和(14.91±4.99)ug/mL,t=-5.41,P=0.00];(2)A组治疗前后异烟肼的血药浓度统计学无显著性差异[分别为(2.89±0.78)ug/mL和(2.92±0.71)ug/mL,t=-0.18,P=0.86];(3)A组与B组比较,A组利福平的血药浓度较B组显著降低[分别为(8.56±4.04)ug/mL和(14.24±3.48)ug/mL,t=-5.77,P=0.00];(4)A组与B组,两组异烟肼的血药浓度统计学无显著性差异[分别为(2.89±0.78)ug/mL和(2.96±0.96)ug/mL,t=-0.29,P=0.77].结论 肺结核患者体内异烟肼的血药浓度高低不受血糖的影响,但普遍偏低,利福平的血药浓度有可能受血糖高低的影响,血糖的控制有可能会提高利福平的血药浓度,因此要注意监测其血药浓度并及时调整给药剂量.