伴肝功能受损肺结核患者血清中利福平的测定及个体化给药

Determination of Serum Rifampin and Individualized Dose in Tuberculosis Patients with Liver Damage

目的 :建立人血清中利福平浓度的测定方法 ,并对肝损肺结核患者个体化用药。方法 :以对硝基苯酚为内标 ,采用Lichro spher100(4 6μm×250mm )为分析柱 ,柱前加YWG -C18(Φ4mm×40mm )保护柱 ,以甲醇 -乙腈 -0 04mol/LKH2PO4(31 5∶31 5∶37 ,V/V/V )为流动相 ,流速为1ml/min ,柱温为40℃ ,检测波长为254nm ,测定患者口服利福平450mg 后经 -时血清浓度 ,并判断患者是否需要剂量调整。结果 :本法分离良好 ,不受干扰。利福平在肝损肺结核患者中存在明显的个体差异 ,经剂量调整后 ,疗效明显 ,不良反应减少。结论 :本法简便快速、准确灵敏、重现性好、检测范围广 ,适用于利福平化疗方案的个体化用药分析。

OBJECTIVE:To establish a method for determination of Rifampin in human serum,and to individualize the medication for tuberculosis patients with liver damage.METHODS:Using d-nitrophenol as the internal standard,the serum samples were extracted with methanol.HPLC condition:analytical column:Lichrospher100(4.6μm×250mm),guard column:YWG-C 18 (Φ4mm×40mm),the mobile phase:methanol-acetonitril-0.04mol/L KH 2 PO 4 (31.5∶31.5∶37,V/V/V),the flow rate:1ml/min,the column temperature:40℃,the wavelength of UV detection:254nm.The serum concentrations were deterˉmined at given time periods after patient taking an oral dose of450mg Rifampin,and need of dosage adjustment was judged.RESULTS:The chromatography was good and not interfered by the components of the serum.The dosage of Rifampin had obvious individual difference.After adjusting the dosage,the effect increased and ADRs decreased.CONCLUSION:This is a simple,rapid,accurate,sensitive and reliable method to determine the concentration of Rifampin with a wide concentration range.It is suitable for the analysis of individualized medication of Rifampin.