| Objective:With the global tuberculosis epidemic rebounding, drug--induced liver injury by the anti-TB drugs are more common in clinical. The combination chemothera-py of Isoniazid, rifampicin and pyrazinamide,is effective short-course chemotherapy sche-me which is recommended for TB patients. The liver is the main site of drug metab-olism, and it is also a target organ for drug toxicity,which is vulnerable to damage by drugs. Clinicians face complicated diseases, to understand the differences between the TB patients with hepatotoxicity and simple TB patients in the pharmacokinetics of, we take Isoniazid for example.To understand what the different test results in serum concentrations in the peak time,the effective duration of soniazid blood concentration, the peak concentration between the TB patients with hepatotoxicity and the TB patie-nts without hepatotoxicity,when they both take the regular doses of isoniazid (0.3 g.Q d).Methods:On one hand Consecutive picking up 30 cases from the inpatient tuberculosis patients with hepatotoxicity from the January of 2009 to the December of 2009 in Tianjin Haihe Hospital,and then making them take isoniazid(0.3g, Q d) for 5 days,in the early morning without eating anything at least 8 hours,according to the regular is-oniazid pharmacokinetic characteristics, respectively taking the patients vein blood b-efore taking the medicine,after taking the medicine 1 hour,2 hours,4 hours,6 hours,8 hours,12 hours,and then using HPLC (High Performance Liquid Chromatography) to detect and record the plasma concentration of isoniazid as the study group;on another hand selecting 30 cases from the inpatient TB patients without hepatotoxicity in the s-ame period, detecting and recording the plasma concentration of isoniazid in the same way as the control group. Date processing by SPSS 16.0.Results:In the term of isoniazid's peak concentration in the serum in the peak time (1 ho-ur or 2 hours) of the two groups, there are 24 cases (80% in this group) the study gro-up which reach the peak concentration in one hour, and are 6 cases(20%,in this grou- p), w-hile in the control group there are 16 cases(53.33%) and 14 cases(46.67%), res-pectively. There are Significant differences between the two groups (x2= 4.8, P< 0.05); In the term of duration of the effective concentrations of isoniazid, it is 10.20±2.48 hours in the study group, and corresponding,7.47±2.22 hours in the control gr-oup, so there exits the statistically significant difference (t=4.49, P<0.05) between the two g- roups; In the term of the peak concentration of isoniazid, the peak concen-tration of is- oniazid is 8.85±3.59mg/l in the study group,and correspondingly, it is 4.51±1.42 mg/l in the control group, there exits the statistically significant difference between t- he two groups (t'-6.113, P<0.05).Conclusion:Combined with clinical, the study group is earlier in the peak time, longer in the effective duration of soniazid blood concentration, and higher in the peak concentrat-ion than the control group.Based on the results of this experiment, it is much more i-mportant for the tuberc- ulosis patients with hepatotoxicity to administrate the anti- T B drugs according to the blood concentration, to achieve effective treatment at the sa-me time to try to a- dvoid the occurrence of adverse side effects. |
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