肺结核合并糖尿病对抗结核药物血药浓度的影响

目的 研究肺结核合并糖尿病对吡嗪酰胺、左氧氟沙星的血药峰浓度的影响，为糖尿病合并肺结核患者用药提供理论依据。方法 以随机数字表法选取糖尿病合并肺结核的患者为观察组（左氧氟沙星组30例，吡嗪酰胺组20例），单纯肺结核为对照组（左氧氟沙星组30例，吡嗪酰胺组20例），两组分别服用抗结核药物吡嗪酰胺、左氧氟沙星，在服药7 d后，用高效液相色谱法（HPLC）测定患者抗结核药物的血药峰浓度，两组间进行对比，采用SPSS 13.0软件进行统计分析。结果 左氧氟沙星在糖尿病合并肺结核组的血药峰浓度较单纯肺结核组明显升高［分别为（8.03±2.60）μg/ml和(6.66±1.76) μg/ml，t=2.39，P=0.02］；而吡嗪酰胺在两组间差异无统计学意义［分别为(14.24±4.79)μg/ml和(14.86±5.74)μg/ml，t=0.37，P=0.71］。结论 左氧氟沙星在糖尿病合并肺结核患者体内的血药峰浓度较单纯肺结核患者明显升高，提示糖尿病患者在应用左氧氟沙星时应该注意其血药峰浓度。有无糖尿病对吡嗪酰胺在体内血药浓度没有影响。

Study on the effects of blood concentration of anti-tuberculosis drugs in pulmonary tuberculosis patients with diabetes

Objective To study the effects of blood concentration of 2 anti-tuberculosis drugs,levofloxacin(Lfx) and pyrazinamide(PZA) in pulmonary tuberculosis patients with diabetes.Methods The levels of serum Lfx and PZA were measured by high performance liquid chromatography(HPLC) in pulmonary tuberculosis patients with diabetes,and compared with patients without diabetes.The data were calculated by SPSS 13.0 software.The drug concentration of Lfx and PZA were analyzed in pulmonary tuberculosis patients with diabetes,and compared with patients without diabetes.Results The drug concentration of Lfx was higher in pulmonary tuberculosis patients with diabetes than that in the patients without diabetes,(8.03±2.60) μg/ml and(6.66±1.76) μg/ml,t=2.39,P=0.02).There was no significant difference between the 2 groups on the drug concentration of PZA((14.24±4.79) μg/ml and(14.86±5.74) μg/ml;t=0.37,P=0.71).Conclusion The drug peak concentrations of Lfx were affected by the factors of diabetes.The peak drug concentrations of PZA were not affected by diabetes.