万古霉素在老年感染患者体内的群体药代动力学研究  

Population pharmacokinetics of vancomycin in elderly infectious patients

作　　者：朱敏 张翠锋 过怿赟[2] 祝子明 ZHU Min;ZHANG Cuifeng;GUO Yiyun;ZHU Ziming(Department of Pharmacy,the People's Hospital of Xuancheng City,Xuancheng 242000,Anhui,China;Department of Clinical Pharmacy,Yijishan Hospital of Wannan Medical College,Wuhu 241000,Anhui,China)

机构地区：[1]宣城市人民医院药学部 [2]皖南医学院弋矶山医院临床药学部

出　　处：《中国临床药理学与治疗学》2019年第2期158-163,共6页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：国家自然科学基金资助项目(81173134);皖南医学院中青年科研基金(WK2015F11)

摘　　要：目的:建立万古霉素在老年感染疾病患者体内的群体药代动力学模型,探讨其药代动力学特征及可能的影响因素。方法:71例老年感染患者的130个稳态血药浓度监测数据纳入本次研究,应用Phoenix NLME(Version 8.0)软件中的群体模块分析万古霉素静脉滴注后的血药浓度数据,估算相关药代动力学参数及其变异情况,构建万古霉素在老年患者中的群体药代动力学模型,并对最终模型进行验证。结果:采用一房室模型拟合所收集的万古霉素血药浓度数据,表观分布容积V和药物清除率CL的群体典型值分别为33.44 L和2.16 L/h。协变量筛选结果显示,肌酐清除率Ccr对药物清除率CL有显著影响(P<0.01)。结论:本研究成功建立了万古霉素在老年感染疾病患者体内的群体药代动力学模型,最终模型可对个体药代参数做出精确的估计,Ccr对药物清除率CL有显著影响。AIM:To develop a population pharmacokinetic model of vancomycin in elderly infectious patients and evaluate the effect of individual factors on the pharmacokinetics of vancomycin.METHODS:A total of 130 steady state blood vancomycin concentration monitoring data were collected from 71 cases of elderly infectious patients.Phoenix NLME(Version 8.0)software was used to assess the influence of demographic characteristics on pharmacokinetic characters of vancomycin and establish the vancomycin population pharmacokinetics model in elderly patients.Then,verify the final model.RESULTS:One-compartment model was fitted to the vancomycin concentration data.The population value of V and CL were 33.44 L and 2.16 L/h,respectively.CL was found to be significantly related to the covariate of Ccr(P﹤0.01).CONCLUSION:The population pharmacokinetic model of vancomycin was established successfully in elderly infectious patients.The final model could be used to provide accurate individual pharmacokinetic parameters.CL was significantly influenced by the covariate of Ccr,which showed that it is better to administer drug according individual Ccr in clinical practice.

关 键 词：万古霉素 老年感染患者 群体药代动力学 

分 类 号：R969.1[医药卫生—药理学]