The Relationship Between Concentrations Of Isoniazid In Cerebrospinal Fluid And Curative Effects In Patients With Tuberculous Meningitis

Objective：To investigate different concentrations of isoniazid in theCSF of patients with tuberculous meningitis by non intrathecal injectionand intrathecal injection with different doses of Isoniazid. As well as thecorrelation of different dosages of isoniazid, different concentrations ofIsoniazid in the CSF and clinical efficacy, adverse effects.Methods：11of50patients with clinically diagnosed tuberculousmeningitis were given300mg isoniazid per day,10patients were given600mg isoniazid per day,20patients were given900mg isoniazid perday.19patients who used600mg isoniazid treatment were divided intointrathecal injection group(9cases) and non intrathecal injection group(10cases).All of50patients used HPLC method for the determination ofisoniazid groups in cerebrospinal fluid, and analyzed the therapeuticefficacy and untoward reaction.Results：There are statistically significant differences concentration ofisoniazid of cerebrospinal fluid in300mg group,600mg group,900MG group (P＞0.05)。No statistically significant differences was intrathecalinjection group and non intrathecal injection group（P＞0.05）. Theeffective rate of900mg group76.5%，600mg group57.1%（P＞0.05），intrathecal injection group100%，non intrathecal injection group57.1%（P＜0.05）；The clinical detection indexes in CSF had statistical change afterINH intrathecal injection therapy or900mg insoniazid were given.Theimprovement rate of CSF in900mg group and600mg group was88.2%，70%（P＞0.05），intrathecal injection group100%，non intrathecal injectiongroup70%（P＜0.05）。The untoward reaction happened in900mg groupand600mg group,was70%，30%（P＜0.05）.Conclusion：The higher dose of INH leads to higher drug concentrationin CSF, so as to indexes recovery in CSF. However it would cause higherrisks of untoward effects incidence. Through our clinical observation, therewas no therapeutic difference among series of dose of INH, when theconcentration was above the required therapeutic dose. And intrathecalinjection of INH would be no helpful to effectively increase drugconcentration in CSF, however it would lead to better clinical therapeuticeffects and indexes recovery as well compare to oral administration route.