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中国防痨杂志 ›› 2020, Vol. 42 ›› Issue (5): 493-497.doi: 10.3969/j.issn.1000-6621.2020.05.014

• 论著 • 上一篇    下一篇


张培泽, 郑俊峰, 曹炜鹏, 王玉香, 陈涛, 付亮, 邓国防()   

  1. 518112 深圳市第三人民医院肺二科
  • 收稿日期:2019-11-13 出版日期:2020-05-10 发布日期:2020-05-08
  • 通信作者: 邓国防
  • 基金资助:

Study of the serum concentration at two time points after taking rifampicin

ZHANG Pei-ze, ZHENG Jun-feng, CAO Wei-peng, WANG Yu-xiang, CHEN Tao, FU Liang, DENG Guo-fang()   

  1. Department II of Tuberculosis, the Third People’s Hospital of Shenzhen, Shenzhen 518112, China
  • Received:2019-11-13 Online:2020-05-10 Published:2020-05-08
  • Contact: DENG Guo-fang


目的 评价以服用利福平后2h和6h两个时间点血药浓度(C2h和C6h)作为最大血药峰浓度(Cmax)指导临床用药的可行性。方法 收集2016年11月至2017年11月深圳市第三人民医院收治的确诊为活动性结核病且符合入组标准的148例患者,采用高效液相色谱法监测患者服用利福平1周后的C2h和C6h血药浓度水平资料,以国际通用利福平的血药Cmax(8~24μg/ml)为标准,采用SPSS 19.0软件比较两个时间点血药浓度水平及吸收不良和吸收延迟情况,并初步分析低血药浓度组(未达标者)与正常血药浓度组在性别、年龄、BMI、利福平使用量、并发糖尿病、并发乙型肝炎、血清白蛋白水平等方面的差异,其中计量资料以“ x ˉ ±s”表示,采用t检验;计数资料的比较采用χ 2检验。均以P<0.05为差异有统计学意义。结果 24.3%(36/148)的患者利福平C2h血药浓度未达标,但其中有13例(36.1%,13/36)服药后C6h血药浓度达标,共计125例(84.5%,125/148)在服药后6h达标,利福平延迟吸收率为10.4%(13/125)。低血药浓度组与正常血药浓度组在男性[60.9%(14/23)和68.8%(86/125)]、年龄[(36.9±4.2)岁和(38.2±3.5)岁]、BMI[ (21.5±4.0)和(22.9±3.7)]、利福平450mg/d使用量[60.9%(14/23)和43.2%(54/125)]、并发糖尿病[8.7%(2/23)和22.4%(28/125)]、并发乙型肝炎[4.3%(1/23)和9.6%(12/125)]、血清白蛋白水平[(42.3±4.4)g/L和(40.9±3.2)g/L]等方面的差异均无统计学意义(χ 2=0.558,P=0.455; t=-1.585,P=0.115;t=-1.647,P=0.102;χ 2=2.442,P=0.118;χ 2=2.257,P=0.166;χ 2=0.669,P=0.694;t=1.457,P=0.157)。结论 服药后两个时间点监测利福平血药浓度水平能更准确反映利福平在体内的吸收情况,但未发现相关影响因素,今后将扩大样本量做进一步研究。

关键词: 利福平, 药物监测, 剂量效应关系,药物, 药代动力学, 结果评价(卫生保健)


Objective To evaluate the application of the peak plasma concentration, which were plasma concentrations of rifampicin (RFP) at 2 h (C2 h) and 6 h (C6 h) post-dose in newly diagnosed active tuberculosis patients, in guidance for clinical management. Methods According to the inclusion criteria, 148 active tuberculosis patients from the Third People’s Hospital of Shenzhen between November 2016 and November 2017 were included, and their C2 h and C6 h were monitored by HPLC one week after taking rifampicin. Based on international rifampicin plasma Cmax (8-24 μg/ml), plasma concentration, malabsorption and delayed absorption of the two time points were analyzed using SPSS 19.0. Gender, age, BMI, rifampicin dosage, concurrent diabetes, concurrent hepatitis B virus and serum albumin levels etc. of the low Cmax group (those who were below the standard range) and the normal Cmax group (those who in the standard range) were described as “ x ˉ ±s” and compared by t test. Categorical variables were compared by χ 2 test and P<0.05 was considered statistically significant. Results C2 h was below the standard range in 24.3% (36/148) of all the patients;however, among them, 36.1% (13/36) patients reached target Cmax (8-24 μg/ml) at C6 h; totally, C6 h of 84.5% (125/148) patients reached the target Cmax, the rate of delayed absorption was 10.4% (13/125). There were no statistical differences between low Cmax group and the normal Cmax group in gender (male, 60.9% (14/23) vs. 68.8% (86/125), χ 2=0.558, P=0.455), age ((36.9±4.2) years vs. (38.2±3.5) years, t=-1.585, P=0.115), BMI ((21.5±4.0) vs. (22.9±3.7), t=-1.647, P=0.102), rifampicin dosage of 450 mg/d (60.9% (14/23) vs. 43.2% (54/125), χ 2=2.442, P=0.118), concurrent diabetes (8.7% (2/23) vs. 22.4% (28/125), χ 2=2.257, P=0.166), complicated with hepatitis B virus (4.3% (1/23) vs. 9.6% (12/125), χ 2=0.669, P=0.694), and serum albumin levels ((42.3±4.4) g/L vs. (40.9±3.2) g/L, t=1.457, P=0.157). Conclusion Monitoring rifampicin Cmax at two time points could reflect the absorption of rifampicin in the body more accurately. However, there was no influence factors been found, and expanded sample for further research would be warranted in the future.

Key words: Rifampin, Therapeutic drug monitoring (TDM), Dose-response relationship,drug, Pharmacokinetics, Outcome assessment (health care)