肾脏病患者应用头孢唑肟的药动学及给药方法  

The pharmacokinetics of Ceftizoxime in patients with renal failure

作　　者：蔡青[1] 崔若兰[1] 李萍[2] 高申[2] 袁彬娥[1] 张国兆[1] 

机构地区：[1]第二军医大学长海医院肾内科,上海200433 [2]第二军医大学临床药理研究室,上海200433

出　　处：《肾脏病与透析肾移植杂志》1996年第2期30-35,共6页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：本文测定了肾功能不全患者及其行血液透析,腹膜透析患者头孢唑肟(CZX)的血药浓度。经计算机自动拟合处理,得出各组病例 CZX 的药动学参数。结果提示,肾功能不全严重影响 CZX 体内代谢,CZX 可被血液透析和腹膜透析清除。肾功能不全患者应减小给药剂量以防积蓄,肾功能衰竭行替代治疗时要调整给药时间和途径。Background Ceftizoxime(CZX)is a third generation cephalosporin antibiotic which is excreted through kidney.In order to evalu- ate the pharmacokinetics of CZX in subjects with end-stage renal failure,hemodialysis (HD)and continuous ambulatory peritoneal dialysis(CAPD),we designed this experi- ment. Experimental design After single,intra- venous dose of 1.0g CZX in 100ml saline, blood,urine or dialysate were collected over a period of 48h in subjects with end-stage renal disease(group A,5 patients,Ccr 16.74±6.66ml/min),HD(group B,4 pa- tients,Ccr<5.0ml/min)and CAPD(group C,10 patients).CZX were assayed by high pressure gas chromatography(HPGC)in all samples.The pharmacokinetic parameters of the CZX were calculated after computer au- tomatic fit. Results The clearance of CZX in group A, B and C were 20.38±8.93ml/min,82.5± 14.0ml/min and 15.0±5.0ml/min respec- tively.Comparing group A and C with B, both the difference were significant(P< 0.001),showing CZX was partly eliminated during HD.The half-life of CZX in healthy person was 1.339±0.261h,but in group A was 24.94±19.97h(P<0.001),group B was 4.33±1.66h(P<0.05),group C was 16.9±4.5h(P<0.001),showing the clear- ance of CZX has been decreased in renal failure and renal replaced therapy patients. Conclusions To maintain the maximal ef- fect and minimal side effect,the recommend- ed dose of CZX is 1.0g a day in patients with end-stage renal disease,1.0g before HD and 0.5g after HD in patients with hemodialysis and 0.125g four times a day in peritoneal dialysate in patients with CAPD. The dose should be doubled if the infections are severe.

关 键 词：肾疾病 头孢唑肟 药物动力学 药理学 

分 类 号：R692.05[医药卫生—泌尿科学] R978.11[医药卫生—外科学]