服用利福平后2h和6h血药浓度作为药峰浓度指导临床用药的可行性研究

Feasibility Study About Maximum Plasma Concentration Upon 2h and 6h After Taking Rifampicin to Guide Clinical Drug Use

目的:研究服用利福平后2h和6h时间点血药浓度(C_(2h)和C_(6h))作为最大血药峰浓度,指导临床用药的可行性。方法:选择本院2018年3月~2020年4月纳入的活动性结核病患者115例作为研究对象,利用高效液相色谱法分别对其服用利福平后2h和6h时间点血药浓度进行监测,观察服用利福平后2个时间点的血药浓度达标结果,并对比低血药浓度组与正常血药浓度组在年龄、性别、体重、利福平使用剂量、合并乙型肝炎、合并糖尿病、血清白蛋白指标情况,探究2个时间点血药浓度作为最大血药峰浓度在指导临床用药上的意义。结果:低血药浓度组的年龄、性别、体重、利福平使用剂量、合并乙型肝炎、合并糖尿病、血清白蛋白与正常血药浓度组相比无统计学差异(P>0.05)。正常血药浓度组在C_(2h)和C_(6h)达标率高于低血药浓度组,且组内600mg/d剂量的达标率高于450mg/d(P<0.05)。结论:服用利福平后2h和6h时间点血药浓度可显示出利福平在患者机体中的吸收状况,因此临床实践中可将2h和6h同时作为常规监测时间点,以保证监测结果的精确性。

Objective: To study the feasibility about maximum plasma concentration upon 2h and 6h time points( C_(2h) and C_(6h)) after taking rifampicin to guide clinical drug use. Methods: 115 active tuberculosis patients treated in our hospital from March 2018 to April 2020 were selected as research subjects. High-performance liquid chromatography( HPLC) was used to monitor the plasma concentrations upon 2h and 6h after taking rifampicin.The results of plasma concentrations at 2 time points after taking rifampicin were observed. Age,gender,body mass,dosage of rifampicin,complication of hepatitis B and diabetes mellitus and levels of serum albumin between the low concentration group and the normal concentration group were compared. Clinical significance of maximum plasma concentrations at two time points to guide drug use was explored. Results: Age,gender,body mass,dosage of rifampicin,complication of hepatitis B and diabetes mellitus and levels of serum albumin between low concentration and normal concentration group were not significantly different( P > 0. 05);at C_(2h) and C_(6h),the plasma concentration standard ratio in normal concentration group was significantly higher than low concentration group;the plasma concentration standard ratio in 600 mg/d patients was higher than 450 mg/d patients in the normal concentration group( P < 0. 05). Conclusion: Upon 2h and 6h after taking rifampicin,plasma concentrations can accurately display the absorption status of rifampicin in patients. Therefore,in clinical practice,2h and 6h can be used as routine monitoring time points simultaneously to ensure the accuracy of monitoring results.