液相色谱串联质谱法检测抗结核药物血药浓度情况的临床分析OA北大核心CSTPCD

Objective:To assess the plasma concentrations of first-line antituberculosis drugs in patients diagnosed with pulmonary tuberculosis using liquid chromatography-tandem mass spectrometry.Methods:This retrospective study enrolled patients treated for pulmonary tuberculosis at the Shandong Public Health Clinical Center from January to December 2023.Patients included in the analysis underwent first-line antituberculosis drug plasma concentration measurements.The cohort comprised 144 patients administered ethambutol(EMB;0.75 g orally once daily),209 patients given isoniazid(INH;0.3 g orally once daily),78 patients prescribed pyrazinamide(PZA;0.75 g orally twice daily),and 181 patients on rifampicin(RFP;0.6 g orally once daily).Demographic data,including age and gender,as well as the results of blood drug concentration measurements for first-line antituberculosis drugs,were collected.The study analyzed plasma concentrations of EMB,INH,PZA,and RFP two hours post-administration,assessing their correlations with gender and age.Results:Two hours following administration,a significant proportion of patients exhibited plasma drug concentrations below the established reference ranges:62.5％(90/144)for EMB,54.1％(113/209)for INH,34.6％(27/78)for PZA,and 22.7％(41/181)for RFP.Subgroup analyses revealed gender-related differences in plasma drug concentrations below the therapeutic threshold:67.4％(64/95)of male patients for EMB(＜2 mg/L),53.1％(68/128)for INH(＜3 mg/L),38.9％(21/54)for PZA(＜20 mg/L),and 25.9％(30/116)for RFP(＜8 mg/L);compared to 53.1％(26/49),55.6％(45/81),25.0％(6/24),and 16.9％(11/65)of female patients for the same drugs,respectively.However,these differences were not statistically significant(x2 values were 2.823,0.118,1.416,and 1.900 with P values of 0.093,0.731,0.234,and 0.168,respectively).Additionally,no correlation was observed between the age distribution of the study subjects and the prevalence of sub therapeutic drug concentrations.Conclusion:It is frequently observed that patients with pulmonary tuberculosis exhibit subtherapeutic plasma concentrations of first-line antituberculosis drugs just two hours post-administration.Notably,the prevalence of low plasma concentrations is higher for EMB and isoniazid INH compared to PZA and RFP.