耐药结核病治疗药物血药浓度监测的研究进展

doi:10.19982/j.issn.1000-6621.20260381

摘要/Abstract

摘要：

结核病是严重威胁人类健康的公共卫生问题,耐药结核病的出现与传播极大地增加了治疗难度,优化耐药结核病治疗方案、提升治疗疗效是当前临床研究的重点。抗结核药物血药浓度直接影响治疗效果与安全性,精准监测血药浓度并据此调整给药方案,是实现耐药结核病个体化治疗的关键。作者系统梳理耐药结核病治疗药物监测(therapeutic drug monitoring,TDM)相关研究进展,从检测技术、有限采样策略、多元化生物样本体系等维度总结TDM方法学革新;归纳贝达喹啉、普托马尼、利奈唑胺、德拉马尼、氟喹诺酮类、氯法齐明等抗结核药物的血药浓度特征,以及各类药物联用的代谢交互与血药浓度变化规律, 为临床合理用药提供参考。

关键词: 结核, 抗结核药, 药代动力学

Abstract:

Tuberculosis remains a major public health threat to human health. The emergence and spread of drug-resistant tuberculosis (DR-TB) have significantly increased treatment difficulty. Optimizing DR-TB treatment regimens and improving therapeutic efficacy are key priorities in current clinical research. Anti-tuberculosis drug concentrations directly affect treatment outcomes and safety; precise therapeutic drug monitoring (TDM) with subsequent dose adjustment is essential for individualized DR-TB therapy. The authors systematically review research advances in TDM for DR-TB treatment, summarizing methodological innovations in assay technologies, limited sampling strategies, and diversified biological sample matrices. This review also consolidates the pharmacokinetic characteristics of bedaquiline, pretomanid, linezolid, delamanid, fluoroquinolones, and clofazimine, as well as metabolic interactions and plasma concentration changes associated with combination therapy, to provide evidence-based guidance for rational clinical prescribing.

Key words: Tuberculosis, Antitubercular agents, Pharmacokinetics

中图分类号:

石文卉, 聂文娟, 初乃惠. 耐药结核病治疗药物血药浓度监测的研究进展[J]. 中国防痨杂志, 2026, 48(10): 1645-1658. doi: 10.19982/j.issn.1000-6621.20260381

Shi Wenhui, Nie Wenjuan, Chu Naihui. Research progress on blood drug concentration monitoring of therapeutic drugs for drug-resistant tuberculosis[J]. Chinese Journal of Antituberculosis, 2026, 48(10): 1645-1658. doi: 10.19982/j.issn.1000-6621.20260381

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