连续性肾脏替代治疗对抗菌药物的影响  

Influence of Continuous Renal Replacement Therapy on Antibiotics

作　　者：董佳慧[1] 孙耕耘[1] Dong Jia-hui;Sun Geng-yun(Department of Respiratory and Critical Care Medicine,The First Affiliated Hospital of Anhui Medical University,Hefei 230022)

机构地区：[1]安徽医科大学第一附属医院呼吸与危重症医学科,合肥230022

出　　处：《国外医药（抗生素分册）》2021年第3期129-135,共7页World Notes on Antibiotics

摘　　要：连续性肾脏替代治疗(CRRT)是一种新兴的肾脏替代方式,由于其接近肾脏生理模式,适用于血流动力学不稳定者,在临床上越来越广泛地应用于危重症患者。对于接受CRRT的重症患者而言,合理使用抗菌药物至关重要。医务人员为接受CRRT的患者选择和使用抗菌药物时,应关注相关研究进展,综合考虑多种因素,结合血药浓度监测结果,形成个体化给药方案。然而现有的循证医学资料较为有限,目前还没有相应的临床指南。因此,还需要更多大样本的临床研究来明确CRRT对抗菌药物的影响,进一步指导临床决策。作者从CRRT模式和参数、药物代谢动力学(PK)和药物效应动力学(PD)特点以及机体疾病状态等方面进行了分析,阐述了CRRT对不同种类抗菌药物的影响。As an emerging mode of renal replacement,continuous renal replacement therapy(CRRT)is becoming more and more widely used in critically ill patients because of its similarity to kidney physiology,which is suitable for hemodynamic instability.For the critically ill patients treated with CRRT,rational use of antimicrobial agents is crucial.When selecting and using antibacterial drugs on patients receiving CRRT,relevant research progress and various factors combined with results of blood drug concentration monitoring should be focused for the formation of individualized dosage regimen.Since the existing information of evidence-based medicine is limited,there is no corresponding clinical guideline.Therefore,more clinical studies of large sample are needed to verify the influence of CRRT on antimicrobial agents,and to guide the clinical decision making.This review expounds the influence of CRRT on different kinds of antimicrobial agents from the perspectives of CRRT modes and parameters,pharmacokinetics(PK)and pharmacodynamics(PD)and states of illness.

关 键 词：连续性肾脏替代治疗 抗菌药物 药物代谢动力学 药物效应动力学 

分 类 号：R978.1[医药卫生—药品]