艾滋病合并结核病患者抗结核药物血药浓度的研究

目的：比较艾滋病合并结核病人同单纯结核病人抗结核药物血药浓度是否存在差异;比较艾滋病合并结核病病人CD4＋T淋巴细胞水平与抗结核药物血药浓度是否存在相关性。方法：高效液相色谱法测定28例艾滋病合并结核病患者及28例单纯结核病人血清中利福平,异烟肼及吡嗪酰胺血药浓度,比较两组病人抗结核药物血药浓度是否存在差异。用流式细胞仪测定艾滋病合并结核病病人CD4＋T淋巴细胞水平,比较其与抗结核药物血药浓度是否存在相关性。结果：艾滋病合并结核病组病人利福平血药浓度低于单纯结核病人（t=-6.563,P=0.000）。两组病人异烟肼血药浓度对比无统计学差异（t=-0.675,P=0.506）。两组病人吡嗪酰胺血药浓度对比无统计学差异（t=0.063,P=0.951）。CD4＋T淋巴细胞水平与血清中利福平浓度无相关性（r=0.38,P=0.099）,CD4＋T淋巴细胞水平与血清中异烟肼浓度无相关性（r=0.081,P=0.681）,CD4＋T淋巴细胞水平与血清中吡嗪酰胺浓度无相关性（r=0.125,P=0.527）。结论：艾滋病合并结核病病人利福平血药浓度低于单纯结核病人。两组病人异烟肼及吡嗪酰胺血药浓度无差异。CD4＋T淋巴细胞水平与血清中利福平,异烟肼,吡嗪酰胺血药浓度无相关性。

Study on blood concentration of anti-TB drugs in patients with AIDS complicated by tuberculosis

Objective:To compare differences in blood concentration of anti-TB drugs between treating patients with AIDS complicated by tuberculosis and tuberculosis,and to explore correlation between the level of CD4+ T lymphocyte and blood concentration of anti-TB drugs in patients with AIDS complicated by tuberculosis. Methods:Blood concentrations of rifampicin,isoniazid and pyrazinamide in serum of 28 patients with AIDS complicated by tuberculosis and 28 patients with tuberculosis were respectively detected by high performance liquid chromatography.The difference of blood concentration of anti-TB drugs were compared in the two groups.The level of CD4+ T lymphocyte in patients with AIDS complicated by tuberculosis were measured by flow cytometry in which correlation analysis of blood concentration of anti-TB drugs was compared between two groups. Results: Study showed that blood concentrations of rifampicin in patients with AIDS complicated by tuberculosis was lower than that of patients with tuberculosis (t=-6.563,P=0.000).There was no significant difference between two groups in blood concentrations of isoniazid(t=-0.675,P=0.506)and pyrazinamide(t=0.063,P=0.951). Moreover,there was no significant difference in correlation of the level of CD4+ T lymphocyte and blood concentration of drugs,including rifampicin(r=0.38,P=0.099),isoniazid(r=0.081,P=0.681)and pyrazinamide(r=0.125,P=0.527)between two groups. Conclusion: Blood concentrations of rifampicin in patients with AIDS complicated by tuberculosis was lower than that of patients with tuberculosis. There was no significant difference in blood concentrations of isoniazid and pyrazinamide between two groups,and there was no significant difference in correlation of level of CD4+ T lymphocyte and blood concentration of drugs,including rifampicin,isoniazid and pyrazinamide between two groups.