Correlation Between Curative Effect and Concentration of Drugs in Cerebrospinal Fluid in Tuberculous Meningoencephalitis

Yan-ling ZHANG; Hua HE; Ying HUANG; Yang LI; Jun-long WANG

doi:10.12259/j.issn.2095-610X.S20211235

Volume 42 Issue 12

Dec. 2021

Turn off MathJax

Article Contents

Article Navigation > Journal of Kunming Medical University > 2021 > 42(12): 151-155

Yan-ling ZHANG, Hua HE, Ying HUANG, Yang LI, Jun-long WANG. Correlation Between Curative Effect and Concentration of Drugs in Cerebrospinal Fluid in Tuberculous Meningoencephalitis[J]. Journal of Kunming Medical University, 2021, 42(12): 151-155. doi: 10.12259/j.issn.2095-610X.S20211235

Citation:

Yan-ling ZHANG, Hua HE, Ying HUANG, Yang LI, Jun-long WANG. Correlation Between Curative Effect and Concentration of Drugs in Cerebrospinal Fluid in Tuberculous Meningoencephalitis[J]. Journal of Kunming Medical University, 2021, 42(12): 151-155. doi: 10.12259/j.issn.2095-610X.S20211235

Citation:

Yan-ling ZHANG, Hua HE, Ying HUANG, Yang LI, Jun-long WANG. Correlation Between Curative Effect and Concentration of Drugs in Cerebrospinal Fluid in Tuberculous Meningoencephalitis[J]. Journal of Kunming Medical University, 2021, 42(12): 151-155. doi: 10.12259/j.issn.2095-610X.S20211235

PDF( 624 KB)

Correlation Between Curative Effect and Concentration of Drugs in Cerebrospinal Fluid in Tuberculous Meningoencephalitis

doi: 10.12259/j.issn.2095-610X.S20211235

1.
Dept. of Infectious Diseases
2.
Dept. of Pharmacy，The 3rd People’s Hospital，Kunming Yunnan 650041，China

Received Date: 2021-09-15
Publish Date: 2021-12-25

Abstract

Abstract

Objectives To explore the drug concentration in cerebrospinal fluid of isoniazid by one and two intrathecal injections after lumbar cisterna catheterization, and to analyze the correlation between concentration and curative effect. Methods Based on the inclusion criteria, 90 patients with tuberculous meningitis were selected and randomly divided into 3 groups with 30 patients in each group, including control group, intrathecal injection A1 group and A2 group, respectively. The 2 intrathecal injection groups received lumbar cistern catheterization. By observing the concentration of isoniazid in the cerebrospinal fluid of the two intrathecal injection groups at 0 h, 6 h and 12 h, the concentration of isoniazid in the cerebrospinal fluid of the one and two intrathecal injections was compared, and the efficacy of the two groups was compared. Result In the control group, the drug concentration in cerebrospinal fluid was lower at 0 h. After 6 h of intrathecal injection, the concentration of isoniazid in cerebrospinal fluid of group A2 was higher than that of group A1, the difference was statistically significant （P < 0.05）. After 2 weeks of treatment, the effective rate of A2 （90.0%） was significantly higher than that of A1 group （66.7%）. Conclusion Intrathecal injection of isoniazid is more effective than peripheral anti-tuberculosis treatment of tuberculous meningitis. Two intrathecal injections in one day can maintain the effective concentration of isoniazid in cerebrospinal fluid for a longer time than one intrathecal injection. It also provides a foundation for developing personalized treatment plan for patients of varying severity.
- Tuberculous meningitis,
- Isoniazid,
- Intrathecal injection,
- Drug concentration

FullText(HTML)

References(20)

References

[1]	Jain S K,Tobin D M,Tucker E W,et al. Tuberculous meningitis:A roadmap for advancing basic and translational research[J]. Nature Immunology,2018,19(6):521-525. doi: 10.1038/s41590-018-0119-x
[2]	Mirjam C. Effect of procalcitionin-guded treatment on antibiotic use and outcome in lower respiratory tract infections:Cluster-randomised,single-blinded intervention trail[J]. Lancet,2004,363(9409):600. doi: 10.1016/S0140-6736(04)15591-8
[3]	刘其会,张文宏. 抗结核药物药动学/药效学研究进展[J]. 中国感染与化疗杂志,2016,16(5):662-666.
[4]	张亮,冯枭,林霏申,等. 异烟肼血药浓度的影响因素分析[J]. 药学与临床研究,2018,26(6):413-416.
[5]	周晛,孙峰,张文宏. 结核性脑膜炎治疗新策略的研究进展[J]. 中华临床感染病杂志,2016,9(5):477-480. doi: 10.3760/cma.j.issn.1674-2397.2016.05.023
[6]	马俊. 测定血浆及脑脊液中异烟肼浓度调整个体化给药方案[C]. 中国药理学会治疗药物监测研究专业委员会. 第二届全国治疗药物监测学术年会会议指南. 中国药理学会治疗药物监测研究专业委员会: 中国药理学会, 2012: 36
[7]	马玙, 朱莉贞, 潘毓萱. 结核病[M]. 北京: 人民卫生出版社, 2006: 254-262.
[8]	Thwaites G,Fisher M,Hemingway C,et al. British infection society guidelines for the diagnosis and treatment of tuberculosis of the central nervous system in adults and children[J]. J Infect,2009,59(3):167-187. doi: 10.1016/j.jinf.2009.06.011
[9]	中华医学会结核病学分会,颅内结核影像学分型专家共识编写组. 颅内结核影像学分型专家共识[J]. 中华结核与呼吸杂志,2015,38(11):805-809.
[10]	方伟军,宋敏,韩远远,等. 颅内结核MRI特征及抗结核化疗过程中MRI表现分析[J]. 新发传染病电子杂志,2020,5(2):107-112. doi: 10.3877/j.issn.2096-2738.2020.02.011
[11]	郎美琦,蒋利,黄佳盛. 抗结核病药物治疗综述[J]. 临床肺科杂志,2010,15(8):1153-1154. doi: 10.3969/j.issn.1009-6663.2010.08.049
[12]	宋艳华,高孟秋,李琦. 结核分枝杆菌对异烟肼和乙硫异烟胺/丙硫异烟胺耐药机制的研究进展[J]. 中国医刊,2020,55(6):604-608. doi: 10.3969/j.issn.1008-1070.2020.06.010
[13]	Jung J A,Kim T E,Lee H,et al. Aproposal for an individualized pharmacogenetic-guided isoniazid dosage regimen for patients with tuberculosis[J]. Drug Des Devel Ther,2015,15(9):5433-5438.
[14]	周俊,刘元,吕小会,等. 异烟肼、利福平和吡嗪酰胺血药浓度的稳定性及差异分析[J]. 中国药物警戒,2019,16(11):678-682,687.
[15]	刘诚诚,金海霞,徐建,等. 结核病患者N一乙酰基转移酶2基因型与异烟肼血药浓度关系的研究[J]. 中国防痨杂志,2013,35(3):179-182.
[16]	中华医学会结核病学分会. 抗结核新药贝达喹啉临床应用专家共识[J]. 中华结核和呼吸杂志,2018,41(6):461-466. doi: 10.3760/cma.j.issn.1001-0939.2018.06.005
[17]	刘会民,张洁,张永进. 我院异烟肼血药浓度监测结果分析[J]. 天津药学,2011,22(6):27-28. doi: 10.3969/j.issn.1006-5687.2011.06.011
[18]	西娜,赵冠人,陈明,等. 高效液相色谱-串联质谱法测定人脑脊液中一线抗结核药浓度[J]. 中国医院用药评价与分析,2020,20(1):69-72.
[19]	魏香兰,方如塘,师延峰,等. 抗结核药物的血药浓度监测结果分析[J]. 中国医院药学杂志,2015,35(21):1918-1921.
[20]	孟繁荣,刘炜雯,吴玲,等. 异烟肼药物浓度及作用时间对结核分枝杆菌生长状态的影响[J]. 国际医药卫生导报,2014,20(24):3719-3721. doi: 10.3760/cma.j.issn.1007-1245.2014.24.016

Relative Articles(20)

Relative Articles

[1]	Nihong LU, Honglu LIU, Yangjun CHEN, Meiyan LIU, Yongrui YANG, Yingrong DU. Analysis of Characteristic Indexes of Liver Injury Model Induced by Different Antituberculosis Drugs in Mice. Journal of Kunming Medical University, 2023, 44(6): 6-13. doi: 10.12259/j.issn.2095-610X.S20230615
[2]	Lianyong CHEN, Haohao RU, Xing YANG, Shuangqun YAN, Tao CHEN, Qinxuan NI, Lin XU. Characteristics of katG and inhA Gene Mutations in INH-Resistant Mycobacterium Tuberculosis in Yunnan Province. Journal of Kunming Medical University, 2022, 43(8): 28-33. doi: 10.12259/j.issn.2095-610X.S20220803
[3]	Ni-hong LU, Hong-lu LIU, Yang-jun CHEN, Yan YANG, Yong-rui YANG, Ying-rong DU. Characteristics of Infection Indexes in Patients with Antituberculous Drug-induced Liver Injury. Journal of Kunming Medical University, 2021, 42(11): 57-61. doi: 10.12259/j.issn.2095-610X.S20211111
[4]	Yan-fen MA, Jian HU, Ning ZHANG, Qian WU, Xiao-qin WANG. Changes and Abnormal Patterns of Coagulation Indicators in Patients with Lung Adenocarcinoma and Tuberculosis Pleural Effusion. Journal of Kunming Medical University, 2021, 42(10): 145-150. doi: 10.12259/j.issn.2095-610X.S20211021
[5]	Na LI, Jie CHEN, Ji LUO, Yong-gang CHEN, Jiang-li PENG, Ming-li YU, Sheng-hao LI. Retrospective Analysis of 376 Cases of Adverse Reactions to Antituberculosis Drug. Journal of Kunming Medical University, 2021, 42(4): 117-121. doi: 10.12259/j.issn.2095-610X.S20210422
[6]	Guo-ji CHANG, Ying HUANG, Yan-ling ZHANG, Hua HE, Jun XU, Yang LI. Comparison of the Efficacy of Ommaya Reservoir and Lumbar Cistern Intervention of Tuberculous Meningoencephalitis Complicated with Hydrocephalus. Journal of Kunming Medical University, 2021, 42(4): 122-127. doi: 10.12259/j.issn.2095-610X.S20210423
[7]	Shu-lan SHI, Xi-ting DAI, Guang-zhou ZHAO, Xiao Juan LI, Rong-jie LI, Ming-biao MA. Application of 16SrRNA Gene Detection in the Early Diagnosis of Bacterial Meningitis in Children. Journal of Kunming Medical University, 2021, 42(5): 120-125. doi: 10.12259/j.issn.2095-610X.S20210522
[8]	Yang LI, Hua HE, Yan-ling ZHANG, Ying HUANG, Jun-long WANG. Changes of Rifampicin Concentration in Cerebrospinal Fluid of Patients with Tuberculous Meningoencephalitis. Journal of Kunming Medical University, 2021, 42(7): 110-114. doi: 10.12259/j.issn.2095-610X.S20210718
[9]	Ma Zhi Qiang , Wang Lin , Wang Xiao Yan , Qu Chun Yan , Gao Xi , Xu Shi Tao , Liu Zi Long . . Journal of Kunming Medical University, 2020, 41(07): 135-139.
[10]	Zhao Heng , Xu Bin , Zhao Guang Zhou , Li Rong Jie , Zhou Bai Ling , Liu Ye , Shi Shu Lan . . Journal of Kunming Medical University, 2020, 41(08): 121-125.
[11]	Hua HE, Ying HUANG, Yan-ling ZHANG, Jun XU, Wen-ming LI, Yun LUO. Comparison of Different Doses of Amphotericin B Intrathecal Injection Combined with Continuous Cerebrospinal Fluid Drainage Replacement in the Treatment of Cryptococcal Meningitis. Journal of Kunming Medical University, 2020, 41(12): 112-118. doi: 10.12259/j.issn.2095-610X.S20201230
[12]	Jie Chun Lin , Huang Tao , Teng Zhao Wei , Bu Jun Hui , Li Meng Zhou , Zhang Jing. . Journal of Kunming Medical University, 2019, 40(04): 91-96.
[13]	He Hua , Huang Ying , Chen Jia , Xu Jun , Li Wen Ming , Luo Yun , Wu Yan , Chen Hai Yun , Wang Li Hua . . Journal of Kunming Medical University, 2019, 40(02): 110-115.
[14]	Li Ming Wu , Ma Meng , Zhang Rui Yu , Lai Ming Hong , Zhu Hui Qiong , Wan Rong . . Journal of Kunming Medical University, 2019, 40(01): 105-108.
[15]	Sun Yu Peng , Zhang Chun Qiang , Du Kai Li , He Shao Bo , Guo Pei Yu , Zhao Run Min . The Value of T-SPOT.TB in Evaluating Treatment Effect of Tuberculous Vertebral Osteomyelitis. Journal of Kunming Medical University, 2018, 39(06): 86-90.
[16]	Dou Quan Li , Zhou Jiu Peng , Yang Yuan Li , Zhang Yong Feng , Dang Li Yun , Sun Hui Ping . Diagnostic Value of a Modified Acid-fast Staining Protocol for Mycobacterium Tuberculosis Detection in Pleural Fluid Samples from Patients with Tuberculouspleuritis. Journal of Kunming Medical University, 2017, 38(09): 35-38.
[17]	Shu Jing Kui . . Journal of Kunming Medical University,
[18]	Yang Jun . . Journal of Kunming Medical University,
[19]	Wan Rong . . Journal of Kunming Medical University,
[20]	Jian Bin . . Journal of Kunming Medical University,