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对10例结脑病人,用生物稀释试管法分别测定氟嗪酸(OFLX)、丁胺卡那霉素(Amikin)血和脑脊液浓度。用药后血浓度(μg/ml)2小时已达高峰,分别为2.3及10.0。脑脊液最高浓度OFLX用药后4小时为0.63,Amikin用药后2小时为0.33。用1％溶血半流培养基,标准菌株H_(37)R_v,测定最低抑苗浓度(MIC)为0.312、0.156,罗氏培养基为2.5～5.0两药治疗结核病能达到有效血浓度,但均不能通过血脑屏障移行到脑脊液。同时对临床分离的11例耐卡那霉素(KM)结核菌株测定对Amikin敏感情况;10例耐药、1例低度敏感,表明Amikin与KM对结核杆菌存在交叉耐药。本文根据血中药物浓度测定的结果,提出OFLX每日300～400mg顿服、Amikin 400mg一次肌注,为治疗结核病可行方案。
In 10 patients with tuberculous meningitis, creatinine (OFLX), Amikin blood and cerebrospinal fluid concentrations were determined by biotilution test. After treatment, blood concentration (μg / ml) peaked at 2 hours and was 2.3 and 10.0, respectively. The highest concentration of cerebrospinal fluid OFLX 4 hours after the 0.63, 2 hours after the Amikin medication was 0.33. With 1% hemolytic half-flow medium and standard strain H_ (37) R_v, MICs of 0.312,0.156 and 2.5 ~ 5.0 in Roche medium were determined to reach the effective blood concentration, but none of them Migration to the cerebrospinal fluid through the blood-brain barrier. Amikin was also detected in 11 kanamycin resistant (KM) tuberculosis isolates clinically isolated. Ten cases were resistant and one case was lowly sensitive, indicating that Amikin and KM were cross-resistant to Mycobacterium tuberculosis. Based on the results of the determination of blood drug concentration, this paper proposed OFLX daily 300 ~ 400mg Dayton, Amikin 400mg once intramuscular injection for the treatment of tuberculosis feasible scheme.