多黏菌素B在脓毒血症患者中的群体药动学研究  

Population Pharmacokinetics of Polymyxin B in Patients with Sepsis

作　　者：张俊[1] 张素枝 孙志[1] 韩冰[2] 孔羽 周霖[1] 朱振峰[1] 罗永刚[2] 张晓坚[1] ZHANG Jun;ZHANG Su-zhi;SUN Zhi;HAN Bing;KONG Yu;ZHOU Lin;ZHU Zhen-feng;LUO Yonggang;ZHANG Xiao-jian(Department of Pharmacy,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Integrated ICU,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院药学部,郑州450052 [2]郑州大学第一附属医院综合ICU,郑州450052

出　　处：《中国药学杂志》2021年第9期744-748,共5页Chinese Pharmaceutical Journal

基　　金：河南省科技攻关项目资助(22170136,212102310321)。

摘　　要：目的建立脓毒血症患者多黏菌素B(polymyxin B,PB)的群体药动学(population pharmacokinetic,PPK)模型。方法收集16例多重耐药革兰阴性菌感染的患者第5剂静脉滴注PB前及滴注后12 h内的血药浓度,采用非线性混合效应程序建立PPK模型。结果PB在脓毒血症患者中的药动学特性符合2-房室模型,未发现对PB药动学参数有影响的协变量,模型评价表明模型稳定,且有较好的预测效能,PB在脓毒血症患者中的剂量调整应参考药动学靶值和细菌的最低抑菌浓度(MIC)值。结论本研究建立了脓毒血症患者PB的PPK模型,可为PB在中国成年脓毒血症患者中的个体化用药提供参考。OBJECTIVE To develop a population pharmacokinetics(PPK)model of polymyxin B(PB)in Chinese sepsis patients.METHODS A total of 16 ICU sepsis patients with multidrug-resistant Gram-negative bacterial infections were included.On the fifth dose,blood specimens were collected before PB administration and up to 12 h after PB dosing.The PPK model was developed by nonlinear mixed effects modeling.RESULTS The PPK character of PB was best described by a two-compartment model.No clinical tested data of patients was identified as a covariate affected the PK parameters of polymyxin B in the studied sepsis population.The individual PB dosage adjustment should based on the PK target and MIC of microorganism in sepsis patients.CONCLUSION The PPK model of PB in sepsis is established successfully and could provide basis for the individualized dosage regimen in adult sepsis patients.

关 键 词：多黏菌素B 药动学 脓毒血症 

分 类 号：R969.1[医药卫生—药理学]