微透析技术在重症脓毒症抗菌药物治疗方面的应用进展  

Application of microdialysis technique in treatment of severe sepsis antibiotic

作　　者：王丹 刘春生[2] 马萍 童卫杭 陈琛 张睢扬[4] 吕伟[5] 周丁华[5] 

机构地区：[1]解放军第二炮兵总医院药学部,北京100088 [2]解放军第二炮兵总医院骨科,北京100088 [3]二炮政治部永定路干休所,北京100039 [4]解放军第二炮兵总医院,北京100088 [5]解放军第二炮兵总医院肝胆外科,北京100088

出　　处：《国际呼吸杂志》2014年第2期136-140,共5页International Journal of Respiration

基　　金：国家自然科学基金青年科学基金（81301662）;中国博士后科学基金（2013M532151）

摘　　要：作为一种新型生物取样技术，微透析技术具有活体、微创、实时、高效等特点。近年来微透析技术已经广泛地应用于临床各个学科，在实验研究、临床诊断和治疗方面都具有积极意义。重症脓毒症和脓毒症休克的患者病理生理学的改变、液体复苏和体内液体的再分布等使药物表观分布容积发生改变，同时经常合并肾功能或肝功能不全引起药代学、药效学特征的变化，以往的评价指标多依赖于血清药物浓度及静态的体外药效学参数，很难真实反映药物的实际情况。研究微透析在重症脓毒血症中的应用，探讨药物在血液和组织中的浓度变化，对重症脓毒血症的治疗具有现实意义。为此本文综合近年文献，对微透析技术在脓毒痒杭菌药物治疗方面的府用讲展作一综沭．As a new biological sampling technique,microdialysis technique has the advantages of in vivo, minimally invasive, real-time, and highly efficiency operation. In recent years, microdialysis technique has been widely used in various clinical disciplines, and it is of positive significance in experimental studies, clinical diagnosis and treatment. The pathophysiological changes, fluid resuscitation, and redistribution of body fluids of severe sepsis and septic shock patients lead to the change of apparent volume of drug distribution, complicated with pharmacokinetic and pharmacodynamic characteristic changes resulted from renal or hepatic dysfunction. Most of the previous evaluation indices depend on serum drug concentrations and static in vitro pharmacodynamic parameters and can rarely reflect the actual drug reaction. The studies on the application of microdialysis in severe sepsis and the changes of drug concentration in the blood and tissues have practical significance in the treatment of severe sepsis. This paper conducts a comprehensive literature review on the application of microdialysis technique in treatment of sepsis.

关 键 词：微透析 脓毒症 抗菌药物 重症监护 

分 类 号：R459.7[医药卫生—急诊医学]