成人脓毒血症患者不同负荷剂量的亚胺培南/西司他丁药动学/药效学参数差异的研究  

Study on the pharmacokinetics and pharmacodynamics of imipenem-cilastatin in adult sepsis patients received different loading doses

作　　者：张娟娟[1,2] 王英[2] 张睢扬[2] 马建新[2] 王东霞[2] 甘乐文[2] 

机构地区：[1]苏州大学研究生学院,江苏苏州215006 [2]中国人民解放军第二炮兵总医院呼吸及重症医学科,北京100088

出　　处：《中华肺部疾病杂志（电子版）》2013年第3期9-13,共5页Chinese Journal of Lung Diseases(Electronic Edition)

摘　　要：目的比较成人脓毒血症患者2h静脉泵入负荷量1.0g与2.0g亚胺培南/西司他丁的%T>4×最低抑菌浓度(MIC),为制定亚胺培南/西司他丁在成人脓毒血症患者的合理用药方案提供参考。方法对10位脓毒血症的患者随机分为实验组和对照组各5例。实验组受试者接受方案1给药即1.0g亚胺培南/西司他丁2.0h静脉泵入;对照组受试者接受方案2给药即2.0g亚胺培南/西司他丁2h静脉泵入。在给药前和给药后0.25、0.5、1、2、4、6、8h抽取静脉血标本测定血药浓度。结果试验组对病原菌MIC为4、2、1mg/L的%T>4×MIC分别为分别为(19.89±4.10)%,(44.66±5.56)%,(68.97±7.47)%。对照组对病原菌MIC为4、2、1mg/L的%T>4×MIC分别为(53.34±7.54)%,(79.45±8.66)%,(105.87±11.14)%。结论①结果提示2h静脉泵入负荷量2.0g亚胺培南/西司他丁的%T>4×MIC值超过静脉泵入1.0g;②随MIC值增加,%T>4×MIC呈下降趋势,对于MIC=4.0mg/L的高病原菌感染,可采用亚胺培南/西司他丁负荷剂量2.0g2h给药。Objective To compare the % T 〉 4 x minimal inhibitory concentration （ MIC ） of imipenemin-cilastatin between 1.0 g and 2.0 g loading doses administration by 2 h infusion with a pump. Then provided the data basis for the rational drug development program of imipenemin-cilastatin in the adult patients with sepsis. Methods 10 patients with sepsis were randomly divided into experimental group and the control group （ n = 5 ）. Experimental group accepted imipenemin-cilastatin in the regimens ： a 2 h infusion of 1.0 g with pumps ; Control group accepted imipenemin-cilastatin in the regimens ： a 2 h infusion of 2.0 g with pumps. Blood samples were collected at the time of 0 h, 0.25 h, 0.5 h, 1 h, 2 h, 4 h, 6 h, and 8 h, respectively, to determine blood drug concentration. Results the experimental groups percentages of the % T 〉 4 × MIC of 1, 2and4 mg/L were 68.97% ±7.47%, 44.66% ±5.56%, 19.89% ±4.10%, the control group of the percentages of the % T 〉 4 × MIC of 1,2 and 4 mg/L were 105.87% ± 11.14%, 79.45% ± 8.66%, 53.34% ± 7.54% , respectively. Conclusion ①The 2.0 g infusions of imipenemin-cilastatin by pump resulted in greater % T 〉 4 × MIC than the 1.0 g infusion ; ②Along with the MIC value increases, % T 〉 4 × MIC is on the decline, for MIC = 4.0 mg/L high pathogen infection, can be used imipenem-cilastatin loading dose 2.0 g 2 h administration.

关 键 词：脓毒血症 亚胺培南 西司他丁 负荷剂量 

分 类 号：R631[医药卫生—外科学]