Determination of three anti-tuberculosis medicines in focus of patients with tuberculosis of the wrist and its clinical significance

Abstract

Objective To study the distribution of rifampicin,isoniazid in tissues of patients with tuberculosis wrist for the sake of providing siven guide toward operation and postoperative chemotherapy.Methods 32 patients with tuberculosis wrist,according to radiographic data,were divided into Center group(group Ⅰ)and Borderline groups(group Ⅱ).All patients received chemotherapy regimen of 3SHR(T)Z/6HR(T).After treatment for4 weeks,the patients'specimen of serum,and tuberculosis tissues(group Ⅰ)including sclerotic bone wall,sub-normal bone and tuberculosis tissues(group Ⅱ)including dissolved bone wall,sub-normal bone were obtained during operation at 1,2 hours respectively after oral medication.Then pretreatment and mensuration using HPLC method were carried out after specimen's removal.Results Concentrations of isoniazid and rifapentine in(group Ⅰ)and(group Ⅱ)sub-normal bone and dissolved bone were abeve the minimal bactericidal concentration values.Concentration of 2 drugs in(group Ⅰ)sclerotic bone wall were much lower than that in sub-normal bone and dissolved bone wall.Conclusion The concentration of 2 drugs in patients sclerotic bone wall of wrist were too lower to eliminate the mycobacterium tuberculosis,while an effective concentration for anti-tuberculosis chemotherapy should be find in sub-normal bone and dissolved bone of wrist.Thus,the sclerotic bone of wrist plays an important role in obstructing the drags penetration into tuberculosis. Key words: Tuberculosis,osteoartieular/DT; Wrist joint; Antitubercular agents/AD/PK