摘要
目的:监测万古霉素在肝移植受者体液内浓度及药代动力学参数,研究万古霉素对肝移植受者并发感染的合理治疗。方法:采用荧光偏振免疫分析仪测定用药前后不同时间体液中万古霉素浓度,以PKBP-N1药代动力学程序计算药代动力学参数,并参照指导临床治疗。结果:肝移植肾功能正常者静滴万古霉素后的药代动力学过程在血中符合开放型三房室模型,在腹水中符合一房室吸收模型。万古霉素谷浓度在血液、腹水及胆汁中分别为(12.58±2.59)mg/L(n=14),(15.30±1.52)mg/L(n=4),及(3.11±0.52)mg/L(n=6)。伴肾功能损害血液滤过者,万古霉素清除明显减缓。结论:肝移植肾功能正常者万古霉素的药代动力学参数与健康正常人无显著差异。万古霉素在肝移植患者血清及腹腔中可迅速达到有效杀菌浓度,使用时应给予药物监测并实施个体化给药方案。
AIM The purpose is to investigate the drug concentration and pharmacokinetic parameters of vancomycin in a patient with liver transplantation and to explore the rational use of the drugs in the recipients complicated with infections. METHODS Concentrations of vancomycin in blood, ascites and bile at different time were measured by fluorescent polarization immunoassay (FPIA). The data were calculated by program PKBP-N1. The doses of vancomycin were adjusted according to the parameters. RESULTS Given by intravenous drip of vancomycin, the trough concentration of vancomycin serum, ascites and bile were 12. 58±2. 59 mg/L, 15. 30±1. 52 mg/L, 3. 11±0. 52 mg/L separately in one patient with normal renal function. In another patient with renal dysfunction treated with CRRT the clearance of vancomycin is very slow. CONCLUSIONS The pharmacokinetic parameters of vancomycin had no obvious difference in the liver recipient from that of the healthy people. The Vancomycin may efficiently reach bactericidal concentration in blood and peritoneal cavity of liver-transplanted recipient. Vancomycin will be cleared slowly in-patient with renal impairment. Individual dose of vancomycin should be given to patient with critical infection post liver transplantation, according to the drug blood concentration.
出处
《江苏药学与临床研究》
2002年第2期4-6,共3页
Jiangsu Pharmacertical and Clinical Research
