美罗培南对丙戊酸钠稳态血药浓度的影响  

Effect of meropenem on steady state plasma concentration of sodium valproate

作　　者：赵婷[1] 王晓雯[1] 李红健[1] 鲍思臣 王婷婷[1] 玛尔江.巴哈提别克 孙力[1] 于鲁海[1] Zhao Ting, Wang Xiaowen,Li Hongjian, Bao Sichen, Wang Tingting, Maerjiang Bahatibieke, Sun Li, Yu Luhai(Department of Pharmacy, People＇s Hospital of Xinjing Uygur Autonomous Region, Urumqi 830001, Chin)

机构地区：[1]新疆维吾尔自治区人民医院药学部,乌鲁木齐830001

出　　处：《中国医药》2018年第7期1091-1094,共4页China Medicine

摘　　要：目的探讨美罗培南对丙戊酸钠稳态血药浓度的影响,为临床合理用药提供参考。方法选择新疆维吾尔自治区人民医院2015年1月至2017年9月联合应用美罗培南和丙戊酸钠并监测丙戊酸钠稳态血药浓度的27例住院患者,分析合用美罗培南前后丙戊酸钠血药浓度的变化及其变化幅度。结果 27例患者在合用美罗培南前丙戊酸钠血药浓度均达到治疗浓度(50~100 mg/L),合用美罗培南后其血药浓度为2~28 mg/L,均降到治疗浓度范围以下,下降幅度为(78±15)%,与合用美罗培南前比较明显降低[(15±10)mg/L比(71±18)mg/L],差异有统计学意义(t=15.408,P<0.001)。依据合用美罗培南前丙戊酸钠血药浓度将27例患者分为50~60 mg/L组(9例)、>60~70 mg/L组(8例)、>70 m/L组(10例),3组患者合用美罗培南后丙戊酸钠血药浓度均低于合用前[(9±6)mg/LL比(51±7)mg/L,(15±5)mg/L比(66±3)mg/L,(15±11)mg/L比(88±13)mg/L](均P<0.05),但3组间下降幅度比较差异无统计学意义(P>0.05)。依据丙戊酸钠用法用量将27例患者分为0.25 g、3次/d组(6例),0.4 g、3次/d组(13例),0.5 g、2次/d组(8例),3组患者合用美罗培南后丙戊酸钠血药浓度均低于合用前[(7±6)mg/L比(64±20)mg/L,(16±12)mg/L比(74±20)mg/L,(15±9)mg/L比(71±16)mg/L](均P<0.05),但3组间下降幅度比较差异无统计学意义(P>0.05)。结论美罗培南与丙戊酸钠联合用药可使丙戊酸钠血药浓度显著降低,临床上应避免二者联用。ObjectiveTo analyze the effect of meropenem on the steady state plasma concentration of sodium valproate. MethodsTwenty-seven in-patients taking meropenem and sodium valproate in People′s Hospital of Xinjing Uygur Autonomous Region were enrolled from January 2015 to September 2017. Steady state plasma-sodium valproate concentration was monitored; changes of the plasma-sodium valproate concentration after taking meropenem were analyzed. ResultsSteady state plasma-sodium valproate concentration in 27 patients was 50-100 mg/L before taking meropenem and it decreased to 2-28 mg/L after taking meropenem, which was below the therapeutic concentration range; the drop range was （78±15）%; the mean steady state plasma-sodium valproate concentration after taking meropenem was significantly lower than that before taking meropenem[（15±10）mg/L vs （71±18）mg/L]（t=15.408, P〈0.001）. According to plasma-sodium valproate concentration before taking meropenem, 27 patients were divided into 50-60 mg/L group（n=9）, 〉60-70 mg/L group（n=8） and 〉70 mg/L group（n=10）; the mean steady state plasma-sodium valproate concentration after taking meropenem was significantly lower than that before taking meropenem in all 3 groups[（9±6）mg/L vs （51±7）mg/L, （15±5）mg/L vs （66±3）mg/L, （15±11）mg/L vs （88±13）mg/L]（P〈0.05）; the drop range showed no significant difference among groups（P〉0.05）. According to dosage of sodium valproate, 27 patients were divided into 0.25 g, 3 times/d group（n=6）, 0.4 g, 3 times/d group（n=13） and 0.5 g, 2 times/d group（n=8）; the mean steady state plasma-sodium valproate concentration after taking meropenem was significantly lower than that before taking meropenem in all 3 groups[（7±6）mg/L vs （64±20）mg/L, （16±12）mg/L vs （74±20）mg/L, （15±9）mg/L vs （71±16）mg/L]（P〈0.05）; the drop range showed no significant difference among groups（P〉0.05）. Conclusionsteady state plasma concentration of sodium valproat

关 键 词：美罗培南 丙戊酸钠 血药浓度 

分 类 号：R978.1[医药卫生—药品]