脓毒症患者连续性血液滤过治疗对首剂利奈唑胺血药浓度的监测分析  

Effect of continuous hemofiltration on serum concentration of first-dose linezolid of sepsis patients

作　　者：汪海源[1] 吴兴茂[1] 臧彬[1] 

机构地区：[1]中国医科大学附属盛京医院重症医学科,辽宁沈阳110004

出　　处：《中华医院感染学杂志》2015年第6期1285-1287,共3页Chinese Journal of Nosocomiology

基　　金：辽宁省自然科学基金资助项目(201102293)

摘　　要：目的：调查肾替代治疗中的连续性静-静脉血液滤过（CVVH）对脓毒症患者首剂利奈唑胺血药浓度的影响。方法调查2011年7月－2012年1月严重脓毒症使用利奈唑胺治疗的18例患者临床资料，根据随机原则分为 CVVH 组 8例 、非 CVVH 组10例，两组均给予首剂利奈唑胺600 mg ，给药时间为1 h ；CVVH 治疗采用统一规格滤器滤过，血流速度设定为150 ml／h ，置换液速度设定为2000 ml／h ；于给药后0、30 min 、1、2、3、5、7、9、11 h 时测定外周血利奈唑胺血药浓度及滤过前后静脉血利奈唑胺血药浓度，同时监测 CVVH 治疗超滤后废液中利奈唑胺的血药浓度。结果两组患者外周静脉血利奈唑胺血药浓度比较差异无统计学意义，CVVH 组平均血药浓度3．35～6．23 mg ／L ，非 CVVH 组为4．34～9．81 mg／L ；CVVH 组滤器前后各时点利奈唑胺的血药浓度的比较差异无统计学意义，滤过前平均血药浓度在4．03～5．93 mg／L ，滤过后平均血药浓度在3．89～5．76 mg／L ；CVVH 治疗超滤后废液中利奈唑胺剂量为26．80～316．96 mg 。结论 CVVH 治疗会降低利奈唑胺血药浓度，但无需调整治疗剂量。OBJECTIVE To observe the effect of continuous venovenous hemofiltration （CVVH） on serum concen-tration of first-dose linezolid of sepsis patients receiving renal replacement therapy .METHODS The clinical data of 18 patients with severe sepsis who were treated with linezolid from Jul 2011 to Jan 2012 were investigated ,then the patients were randomly divided into the CVVH group with 8 cases and the non-CVVH group with 10 cases , both groups were given 600mg of first-dose of linezolid ,with the drug administration time of 1h ,the unified speci-fication of filter was employed in the CVVH ,with the blood flow velocity set as 150 ml/h ,the replacement fluid velocity set as 2 000 ml/h .The serum concentrations of linezolid in peripheral blood were determined at 0 ,30min , 1 ,2 ,3 ,5 ,7 ,9 ,and 11h after drug administration ,and the serum concentrations of linezolid in venous blood were measured before and after the filtration ,meanwhile ,the serum concentrations of linezolid in effluents were monitored after the CVVH .RESULTS There was no significant difference in the serum concentration of linezolid in peripheral venous blood between the two groups .The mean serum concentration was 3 .35-6 .23 mg/L in the CV-VH group ,4 .34 to 9 .81 mg/L in the non-CVVH group .There was no significant difference in the serum concen-tration of linezolid of the CVVH group at the time points before and after the filtration ;the mean serum concentra-tion was 4 .03 to 5 .93 mg/L before the filtration ,3 .89 to 5 .76 mg/L after the filtration ,and the dose of linezolid in the effluents was 26 .80 to 316 .96 mg after the CVVH .CONCLUSION The CVVH may reduce the serum con-centration of linezolid ,but the dosage needs not to be adjusted .

关 键 词：连续性静-静脉血液滤过 脓毒症 利奈唑胺 

分 类 号：R978.1[医药卫生—药品]