利奈唑胺骨水泥析出性能的实验观察  

Elution properties of linezolid bone cement

作　　者：孙长鲛[1] 柴伟[1] 潘勇卫 周勇刚[1] 

机构地区：[1] 解放军总医院骨科, 北京100853 [2] 北京清华长庚医院

出　　处：《中华医学杂志》2014年第25期1976-1978,共3页National Medical Journal of China

基　　金：国家高技术研究发展“863”计划项目（2011AA030101）

摘　　要：目的：观察利奈唑胺骨水泥在预防和治疗人工关节置换术后感染中应用的可行性及最佳使用浓度。方法根据在40 g骨水泥中加入不同剂量的利奈唑胺，将样本共分成6组，每组测定5个样本，Ⅰ～Ⅵ组分别为1.2、2.4、3.6、4.8、6.0、7.2g利奈唑胺，通过高效液相色谱分析法分别测定他们随时间变化的析出浓度。结果利奈唑胺骨水泥样本释放速度与抗生素含量呈正相关，随着抗生素含量增加释放速度也随之增加。不同剂量组的释放时间均可持续到7周，所有样本在第1天内均呈爆发性释放，在第2天后释放量缓慢降低。分别对各时间段的药物析出情况进行方差分析，发现各组的利奈唑胺释放量差异有统计学意义，3.6～7.2 g组的释放量明显高于其他各组。结论利奈唑胺抗生素能够从骨水泥中有效释放，术后第1天要夹闭引流管，使骨水泥释放的高浓度利奈唑胺充分发挥作用。每40 g骨水泥中加入3.6 g利奈唑胺可能达到既杀菌又能节省药物，减少并发症的作用。Objective To explore the elution properties of linezolid bone cement so as to guide the clinical application of linezolid bone cement in the treatment of infection after total joint arthroplasty.Methods The specimens of bone cement （ 40 g each ） were divided into 6 groups depending on mixed different contents with linezolid（5 specimens in each group）, groupⅠ（1.2 g）, groupⅡ（2.4 g）, groupⅢ（3.6 g）, group Ⅳ（4.8 g）, group Ⅴ（6.0 g） and group Ⅵ（7.2 g）.The time-dependent elution of linezolid from bone cement was measured by high performance liquid chromatography （ HPLC ）.Results The release rate of linezolid bone cement samples was positively correlated with the concentration of antibiotics.And he release rate increased with the rising concentrations.The release of all groups dropped dramatically at Day 1.And as of Day 2 there was a slow release at a very low level.The elution of all groups persisted through 7 weeks.The analysis of variance between groups showed significant differences in release rates.And further examination by q test revealed that the release of group of 3.6-7.2 g was significantly higher than other groups.Conclusion The drainage tube should be clamped at Day 1 post-operation so that there is a full release of high concentration of linezolid.Adding 3.6 g linezolid to 40 g cement may provide better cost-effective outcomes.

关 键 词：骨科外科手术 感染 抗生素类 恶唑烷酮类 利奈唑胺 

分 类 号：R687.4[医药卫生—骨科学]