O'Brien J K, Doerfler M E, Harkin T J, Rom W N
Bellevue Chest Service, Department of Medicine, New York University Medical Center, NY 10016, USA.
Lung. 1998;176(3):205-11. doi: 10.1007/pl00007603.
Isoniazid (INH) is one of the most important first line drugs in the treatment of tuberculosis. We utilized high performance liquid chromatography with a hydrazone extraction technique to measure INH in bronchoalveolar lavage (BAL) fluid specimens from six patients with active pulmonary tuberculosis. We found BAL fluid INH levels to be similar to 2-h peak serum levels. The concentration of INH in BAL fluid from lobes with infiltrate was similar to the concentration of INH in BAL fluid from lobes without infiltrate (0.062 microgram/ml and 0.073 microgram/ml, respectively). After adjusting for protein concentration in the BAL fluid, INH levels in lobes with infiltrate were threefold lower than in lobes without infiltrate. The correlation between the concentration of INH in serum and BAL fluid approached significance after correcting for protein (lobes with infiltrate, r2 = 0.60 (p = 0.07); lobes without infiltrate, r2 = 0.50 (p = 0.12). INH penetrates into bronchoalveolar fluid, and concentrations of INH in the BAL fluid suggest that assessment of the INH serum concentration is adequate to evaluate bioavailability of the drug in patients with pulmonary tuberculosis.
异烟肼（INH）是治疗结核病最重要的一线药物之一。我们采用高效液相色谱结合腙萃取技术，对6例活动性肺结核患者支气管肺泡灌洗（BAL）液标本中的INH进行测定。我们发现BAL液中的INH水平与血清2小时峰值水平相似。有浸润的肺叶BAL液中INH浓度与无浸润的肺叶BAL液中INH浓度相似（分别为0.062微克/毫升和0.073微克/毫升）。在对BAL液中的蛋白质浓度进行校正后，有浸润的肺叶中INH水平比无浸润的肺叶低三倍。校正蛋白质后，血清和BAL液中INH浓度之间的相关性接近显著水平（有浸润的肺叶，r2 = 0.60（p = 0.07）；无浸润的肺叶，r2 = 0.50（p = 0.12））。INH可渗透到支气管肺泡液中，BAL液中INH的浓度表明，评估INH血清浓度足以评价肺结核患者中该药物的生物利用度。
