Detection Of The Local Rifampicin Concentration By Using Electrophonophoresis In Patients With Tuberculous Pleurisy

Objective: To observe the changes of rifampicin concentration in pleural effusion on patients with tuberculous pleurisy treated by oral anti-TB chemotherapy drugs and Electrophonophoresis(EP)with rifampicin,and to explore the effectiveness of EP in the treatment of tuberculous pleurisy.the drug concentration of rifampicin in pleural effusion after topical perforation.Methods: The rifampicin concentrations in the pleural effusion of patients were compared before and after treatment.Thirty-five patients with tuberculous exudative pleurisy who met the criteria of admission were enrolled and randomized to receive either oral rifampicin 0.45/0.6,isoniazid 0.3/0.4,pyrazinamide 1.0/1.5,ethambutol 0.75 anti-TB treatment 5 d,thoracoscopy or thoracic drainage closed pleural effusion and leave the chest drainage tube.Five days after anti-TB treatment,5 ml of pleural effusion was obtained after 2 hours of oral rifampicin,and the rifampicin concentration was determined by using High-performance liquid chromatography(HPLC)to be used as a control before local topical treatment.In the drainage side of the chest wall by EP penetration rifampicin treatment,5ml of pleural effusion were extracted immediately,30 min,1 h,2 h,4 h,and 8 h after treatment.HPLC was still used to measure the drug concentration of rifampicin in pleural effusion after topical perforation.Results: A total of 35 patients were enrolled in this study,3 patients were excluded,and the final 32 patients completed the study.The mean basal concentration of rifampicin in pleural effusion was(2.173±1.117)?g/ml in 32 patients treated with 5-day treatment,and the mean concentration of rifampicin in pleural effusion increased to(2.706±1.128)?g/ml and continued to increase gradually.After 2 hours of treatment,the average concentration of pleuropulmonary risperidone reached the peak(3.237±1.152)?g/ml,then decreased gradually,and nearly reached the basal concentration after 5 hours.T test was performed to compare the drug concentration(2.706±1.128)?g/ml and the drug concentration before the drug permeation(2.173±1.117)?g/ml immediately after the ultrasound conductivity was taken,t = 5.129,P <0.05,the difference was statistically significant.The drug concentration of 0.5 h(2.706±1.128)?g/ml,2h(3.237±1.152)?g/ml and 4 h(2.795±1.176)?g/ml after transdermal administration were all higher than the concentration immediate after transdermal administration,and significantly higher than before transdermal administration.The T test differences were statistically significant(P<0.05).Conclusion: Ultrasound-guided local drug penetration can increase rifampicin drug concentration in tuberculous pleurisy pleural effusion,combined with oral drugs can greatly extend the duration of local drug's concentration and effectiveness,this is beneficial for the sterilization effects of rifampicin to take place.