关键词: 潜伏性结核感染, 二维液相色谱法, 利福喷丁, 药物监测, 药物代谢动力学

Abstract: Objective To evaluate the safety and clinical efficacy of blood concentration monitoring of rifapentine in the intervention treatment of latent tuberculosis infection in children, in order to ensure medication safety and reduce adverse reactions of children's medication. Method A total of 110 children with latent tuberculosis infection who received preventive interventional treatment at Shenzhen Third People's Hospital between January 2023 and December 2024 were enrolled, and their rifapentine plasma concentrations were detected and analyzed by two-dimensional high-performance liquid chromatography. Plasma drug concentrations at 1h, 2h, 4h, and 6h under steady-state conditions were collected. Combined with the dosage regimen, demographic characteristics (age, gender, weight) and laboratory test results, the plasma drug concentration after 2h of medication was investigated, and its correlation with gender, age, weight and other factors in tolerance risk was discussed. Result The proportions of subjects whose rifapentine concentrations fell within the therapeutic window (8-30 μg/ml) at 1h, 2h, 4h, and 6h were 71.81%, 88.18%, 81.81%, and 73.63%, respectively, and the plasma drug concentrations at all time points were mainly within the therapeutic window. The proportion of 2h drug concentration in the treatment window was significantly higher than that of the other three, and the difference was statistically significant (χ²=13.74, P<0.001; χ²=4.29, P<0.05; χ²=11.72, P<0.001). Further analysis showed that among the influencing factors leading to 2h plasma drug concentration below the therapeutic range, the concentration in males was slightly lower than that in females, but the difference was not statistically significant (χ²=0.002, P>0.05). The difference between age group (χ²=4.130, P<0.05) and weight group (χ²=4.472, P<0.05) was statistically significant. Conclusion Through therapeutic drug monitoring of rifapentine in children with latent tuberculosis infection, the plasma drug concentration of most children reaches the therapeutic window at 2h after administration, and no increase in the incidence of adverse reactions or abnormalities in laboratory indicators is observed. This method is conducive to achieving precise drug administration and individualized treatment, thereby improving clinical efficacy and medication safety.

Key words: Latent tuberculosis infection, Two-dimensional liquid chromatography, Rifapentine, Drug monitoring, Pharmacokinetics