结核性胸膜炎患者利福平胸水浓度测定及胸膜穿透性研究

Concentration and Penetration of Rifampicin in Patients with Tuberculous Pleura Effusion

目的采用一种快速、灵敏的高效液相色谱法来测量结核性胸膜炎患者胸腔积液和血浆中利福平的浓度,并评价其胸膜穿透性。方法采集14例结核性胸膜炎患者第1天和第3天空腹晨服0.45 g利福平2 h后的胸腔积液及第3天空腹晨服药2 h后的血浆,用高效液相色谱法检测利福平浓度,计算渗透率。结果 14名患者第1天服药2 h后的胸腔积液中利福平浓度是(0.498士0.540)μg/ml,第3天服药后2 h患者胸腔积液中利福平浓度是(1.240士0.665)μg/ml,血浆浓度是(7.997士1.629)μg/ml,利福平进入胸腔积液的渗透速率为15.6%士8.6%。结论初次服利福平2 h后在胸腔积液中的浓度较低,个体差异较大,胸腔积液浓度随着给药次数增加而增加,胸腔积液中利福平浓度远远低于血浆中利福平浓度,结核性胸膜炎患者利福平胸膜穿透率低。

Objective To establish a quick and sensitive high performance liquid chromatograph concentration of rifampicin in pleural effusion with tuberculous pleuritis, and to evaluate the penetration y to measure the of rifampicin into pleural effusion. Methods Pleural effusion in 14 tuberculous pleurisy cases was collected 2 h after administration of rifampicin in the first and the third day. Plasma was also collected in the third day. Rifampin was measured by HPLC. Then the permeation rate of riampicin in pleural effusion was calculated. Results The rifampicin concentration in pleural effusion of 14 patients was （0. 498±0.540） μg/ml at 2 h after administration in the firt day, （ 1. 240 ± 0. 665 ） μg/ml in the third day. The rifampicin concentration of plasma in the third day wa：s （7. 997 ± 1. 629 ） μg/ml, the penetration rate of rifampicin in pleural effusion was 15.6% ± 8.6%. Conclusion The rifampicin concentration in pleural effusion is low at the first day, and raised along with administration times, showing large individual differences. The rifampicin concentration in pleural effusion is lower than plasma level. The penetration of rifampicin in pleural effusion is low.