结核性脑膜炎患者脑脊液中异烟肼浓度与疗效的-第三军医大学学报.docVIP

结核性脑膜炎患者脑脊液中异烟肼浓度与疗效的相关研究 张 翼,吴 晗，牟春地，刘 莉，卢 西，邓钰双，余 刚（400016 重庆，重庆医科大学附属第一医院神经内科） [通信作者] 余 刚， E-mail：yugangw@ [摘要] 目的 研究给予不同剂量的异烟肼（Isoniazid，INH）在结核性脑膜炎患者脑脊液（cerebrospinal fluid，CSF）中浓度差异，以及不同剂量、不同CSF浓度与临床疗效和不良反应的相关性。方法 分别给予异烟肼 300 mg/d300 mg组11例）、600 mg/d（600 mg组19例）、900 mg/d（900 mg组20例）治疗的50例患者入组，收集患者CSF标本，使用高效液相色谱法测定各组CSF中异烟肼300 mg组、600 mg组、900 mg组CSF中异烟肼P＜0.05）；临床疗效有效率300 mg组90.9%，600 mg组68.4%,900 mg组75%（P＞0.05）；300 mg组治疗前后CSF变化无统计学意义（P＞0.05），600 mg组治疗前后CSF压力变化明显（P＜0.01），而蛋白变化无统计学意义（P＞0.05），900 mg组治疗前后CSF变化有显著统计学意义（P＜0.01）；脑脊液好转率300 mg组90.9%，600 mg组63.2%,900 mg组75%；不良反应发生率300 mg组18.2%，600 mg组36.8%，900 mg组70%。结论 给予异烟肼，在CSF中的药物浓度越高，更有利于CSF指标的恢复，但是也增加了不良反应的发生率。 [关键词] 结核性脑膜炎；异烟肼；不同剂量；疗效 [中图法分类号] R742.6 [文献标志码] A The relationship between different concentrations of isoniazid in cerebrospinal fluid and curative effects in patients with tuberculous meningitis Zhang Yi,Yu Gang Department of Neurology, the First Affiliated Hospital, Chongqing Medical University, Chongqing， 400016, China ［Ａｂｓｔｒａｃｔ］ＯｂｊｅｃｔｉｖTo investigate different concentrations of isoniazid in the CSF of patients with tuberculous meningitis by different doses of Isoniazid. As well as the correlation of different dosages of isoniazid , different concentrations of Isoniazid in the CSF and clinical efficacy , adverse effects .Ｍｅｔｈｏｄ11 of 50 patients with clinically diagnosed tuberculous meningitis were given 300mg isoniazid per day,10 patients were given 600mg isoniazid per day,20 patients were given 900mg isoniazid per day.All of 50patients used HPLC method for the determination of isoniazid groups in cerebrospinal fluid, and analyzed the therapeutic efficacy and untoward reaction.ＲｅｓｕｌｔThere are statistically significant differences concentration of isoniazid of cerebrospinal fluid in 300mg group, 600mg group, 900mg group (P＞0.05).The effective rate of 300mg group 90.9%，600mg group 68.4%,900mg group 75%（P＞0.05）；The clinical detection indexes in CSF had statistical change aft