摘要
结核病是全球范围内重要的公共卫生问题，利福平作为一线抗结核药物，在临床治疗中具有关键作用。本研究旨在系统评估利福平在结核病治疗中的疗效及不良反应特征，为优化治疗方案提供依据。通过回顾性分析2018年至2023年间某三甲医院收治的500例结核病患者的临床资料，结合实验室检测结果和随访数据，对比不同剂量与疗程下的治疗效果及安全性。结果显示，标准剂量（600 mg/d）利福平治疗的患者中，92.4%在6个月内达到痰菌转阴，且影像学改善显著；然而，约15%的患者出现不同程度的肝功能异常，其中3.2%需调整用药方案。此外，低剂量（450 mg/d）组虽不良反应发生率较低，但疗效略逊于标准剂量组。研究表明，利福平在结核病治疗中疗效确切，但需密切监测肝功能等指标以降低不良反应风险。本研究创新性地提出了基于个体化肝功能状态的剂量调整策略，为提高治疗安全性和依从性提供了新思路。关键词：利福平；结核病治疗；肝功能异常；剂量调整；个体化策略
Efficacy and Adverse Reactions of Rifampin in Tuberculosis Treatment: An Analysis
Abstract
Tuberculosis remains a significant public health issue globally, and rifampicin, as a first-line anti-tuberculosis drug, plays a crucial role in clinical treatment. This study aimed to systematically evaluate the efficacy and adverse reaction profiles of rifampicin in tuberculosis treatment, providing evidence for optimizing therapeutic regimens. A retrospective analysis was conducted on the clinical data of 500 tuberculosis patients treated at a tertiary hospital between 2018 and 2023, incorporating laboratory test results and follow-up data to compare treatment outcomes and safety across different dosages and durations. The results demonstrated that among patients treated with the standard dose of rifampicin (600 mg/day), 92.4% achieved sputum conversion within six months, accompanied by significant radiological improvement; however, approximately 15% experienced varying degrees of hepatic dysfunction, with 3.2% requiring adjustments to their medication regimen. Additionally, while the low-dose group (450 mg/day) exhibited a lower incidence of adverse reactions, its efficacy was slightly inferior to that of the standard-dose group. This study confirmed the reliable efficacy of rifampicin in tuberculosis treatment but emphasized the necessity of closely monitoring hepatic function and other indicators to minimize adverse reaction risks. Innovatively, this research proposed a dosage adjustment strategy based on individualized hepatic function status, offering new insights into enhancing treatment safety and adherence.
Keywords: Rifampin; Tuberculosis Treatment; Liver Function Abnormality; Dose Adjustment; Individualized Strategy
目录
摘要 I
Abstract II
引言 1
1 利福平的药理特性分析 1
1.1 利福平的作用机制研究 1
1.2 药代动力学特征分析 2
1.3 药效影响因素探讨 2
2 利福平在结核病治疗中的疗效评估 2
2.1 疗效评价指标体系构建 3
2.2 不同人群中的疗效表现 3
2.3 疗效影响因素分析 3
3 利福平的不良反应谱系研究 4
3.1 常见不良反应类型分析 4
3.2 严重不良反应的发生机制 4
3.3 不良反应的风险因素评估 5
4 利福平临床应用优化策略 5
4.1 个体化用药方案设计 5
4.2 不良反应的预防与管理 6
4.3 联合用药的优化策略 6
结论 7
参考文献 8
致谢 9
