危重症感染患者血清中利奈唑胺浓度监测  

Therapy Drug Monitoring of Linezolid in Serum of Critically Ⅲ Patients

作　　者：董海燕[1] 董亚琳[1] 王雪[2] 杨华[1] 李昊[2] 刘娟娟[1] 

机构地区：[1]西安交通大学医学院第一附属医院药学部,西安710061 [2]西安交通大学医学院第一附属医院中心ICU,西安710061

出　　处：《中国药学杂志》2010年第16期1255-1258,共4页Chinese Pharmaceutical Journal

摘　　要：目的监测ICU危重症感染患者利奈唑胺血清药物浓度。方法采用高效液相色谱法监测7例危重感染患者血清利奈唑胺浓度。结果对7例使用利奈唑胺的危重感染患者的34份样本进行了血清药物浓度监测,其中包括5例连续性静脉-静脉血液滤过治疗的患者。7例患者治疗期间利奈唑胺浓度变化明显,平均谷浓度变化范围为1.27～7.59 mg.L-1,病原体最低抑菌浓度为2 mg.L-1,有1例患者利奈唑胺平均谷浓度(1.27 mg.L-1)小于最低抑菌浓度,2例患者谷浓度变化较大(相差近10倍),1例患者虽然药物谷值浓度(7.59 mg.L-1)高于最低抑菌浓度,但感染持续存在,临床治疗结果为无效。结论危重症感染患者应用利奈唑胺后血药浓度变化较大,需要通过治疗药物监测的方法制定个体化给药方案。OBJECTIVE To investigate serum linezolid concentration in critically infectious patients in ICU.METHODS Linezolid concentrations in serum were monitored in seven critical patients by HPLC.RESULTS 34 linezolid serum samples were analyzed in critical patients,including 5 patients undergoing continuous venovenous haemofiltration（CVVH）.Linezolid serum concentrations changed significantly in the seven patients during the treatment,with the average trough concentration range of 1.27-7.59 mg·L^-1.The minimum inhibitory concentration was 2 mg·L^-1.The linezolid trough concentration（1.27 mg·L^-1） in one patient was below the minimum inhibitory concentration,and another patient showed unexpected trough concentration fluctuation（nearly 10-fold）.The clinical outcome of one patients,although his trough concentrations（7.59 mg·L^-1） were above minimum inhibitory concentrations,was failure.CONCLUSION Linezolid serum concentrations in critically ill patients shows significant variability,and serum drug concentration should be monitored in these kinds patients in order to decide individual dosage regimen of linezolid in clinical practice.

关 键 词：利奈唑胺 危重症患者 血清药物浓度 

分 类 号：R969.11[医药卫生—药理学]