治疗性药物监测在结核病治疗中的应用进展

doi:10.3969/j.issn.1000-6621.2021.03.016

摘要/Abstract

摘要：

治疗性药物监测(therapeutic drug monitoring,TDM)是应用血液、尿液或唾液中的药品浓度确定药品剂量,为患者制定治疗方案,以获得最佳疗效,减少耐药及不良反应的检测技术。TDM是个体化治疗的重要策略,可为临床调整药品剂量提供参考。结核病患者血药浓度个体差异大、不良反应多,常导致治疗失败、复发和耐药。目前在结核病治疗中TDM尚未实现标准化,也无任何官方指南。但最近国外的指南推荐对有药品暴露改变风险或预后不良的结核病患者,在治疗期间应行TDM。因此,作者分别就TDM的定义及临床意义、检测技术方法、抗结核药品治疗应用情况作一综述,为临床医师提供参考。

关键词: 药品监测, 结核, 血药浓度

Abstract:

Therapeutic drug monitoring (TDM) is a technique that determining the dose of drugs based on the concentration of drugs in blood, urine or saliva, and developing therapeutic regimens to achieve the best treatment effect, and to reduce the drug resistance and adverse reactions. TDM is an important strategy of individualized treatment, which can provide references for individualized doses. Individual differences were found in blood concentrations of tuberculosis (TB) patients, and there were also many adverse reactions.All of these always caused ineffective treatment, relapse or drug resistance. TDM has not yet been standardized and no official guidelines have been developed in anti-TB therapy. However, TDM were recently recommend in foreign guidelines for TB patients who have risk of drug exposure altered or poor prognosis. Therefore, the authors reviewed the definition and clinical significance of TDM, as well as the detection techniques and methods, and application in anti-TB therapy, in order to provide references for clinicians.

Key words: Drug monitoring, Tuberculosis, Blood concentration

王乐乐, 杨松, 唐神结. 治疗性药物监测在结核病治疗中的应用进展[J]. 中国防痨杂志, 2021, 43(3): 285-290. doi: 10.3969/j.issn.1000-6621.2021.03.016

WANG Le-le, YANG Song, TANG Shen-jie. A review of application of therapeutic drug monitoring in tuberculosis treatment[J]. Chinese Journal of Antituberculosis, 2021, 43(3): 285-290. doi: 10.3969/j.issn.1000-6621.2021.03.016

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