结核患者血清尿酸与吡嗪酰胺血药浓度关系研究  

Studies on the relationship between serum uric acid and plasma concentration of pyrazinamide in patients with tuberculosis

作　　者：陈明[1] 吴珂[1] 吴首蓉 赵冠人[1] CHEN Ming;WU Ke;WU Shou-rong;ZHAO Guan-ren(Department of Pharmacy,the 309th Hospital of PLA,Beijing 100091,China)

机构地区：[1]解放军第309医院药剂科,北京100091

出　　处：《中国药物应用与监测》2018年第5期274-276,共3页Chinese Journal of Drug Application and Monitoring

基　　金：首都临床特色应用研究项目(Z141107002514023);北京药学会2018临床药学研究项目:抗结核药物血药浓度与治疗效果关系研究

摘　　要：目的:分析初治肺结核患者血清尿酸浓度与吡嗪酰胺血药浓度之间的关系。方法:依据纳入和排除标准,收集初治肺结核患者143例,其中男性102例(71.33%),女性41例(28.67%)。采集患者服药5～7 d后服药2 h后的静脉血进行吡嗪酰胺血药浓度监测,利用高效液相色谱-质谱联用设备测定;血清尿酸浓度资料从我院检验科获取。利用SPSS19.0统计学软件,采用卡方检验或t检验,P <0.05为差异具有统计学意义。结果:结核患者在服用吡嗪酰胺后,会出现尿酸升高症状,发生率为88.8%,而与性别、年龄、体质量及吡嗪酰胺血药浓度等没有显著的关系。高尿酸血症多在服用吡嗪酰胺一周后出现,较低的吡嗪酰胺血药浓度可以延迟高尿酸血症出现的时间,但不能降低高尿酸的浓度。结论:结核患者服用吡嗪酰胺后,大多会出现血清尿酸升高的症状,而与吡嗪酰胺浓度之间没有相关性。Objective： To analyze the relationship between serum uric acid and concentration of pyrazinamide in tuberculosis patients for initial treatment. Methods： According to the enrolled and excluded criterion, 143 cases of tuberculosis including 102 males （71.33%） and 41 females （28.67%） were collected. The blood samples were obtained 2 h after taking pyrazinamide from patients who had been taken pyrazinamide for 5 – 7 days. The plasma concentrations of pyrazinamide were detected by high performance liquid chromatography tandem mass spectrometry. The serum uric acid concentration was detected by our laboratory. SPSS19.0 statistical software was employed to analyze the data using chi-square or t test and it was defned as statistical signifcance if P 〈 0.05. Results： 88.8% of tuberculosis patients had hyperuricemia after taking pyrazinamide. And hyperuricemia had nothing to do with sex, age, weight and the concentration of pyrazinamide. Hyperuricemia occurred one week after taking pyrazinamide. Although the low concentration of pyrazinamide could delay the onset of hyperuricemia, it couldn＇t reduce the plasma concentration of uric acid. Conclusion： Most of tuberculosis patients developed hyperuricemia after taking pyrazinamide, which had no relationship with plasma concentration of pyrazinamide.

关 键 词：结核 吡嗪酰胺 血药浓度 尿酸 

分 类 号：R969.4[医药卫生—药理学]