大面积烧伤患者万古霉素给药后不同时间点静脉血和水疱液中的药物浓度及其他药动学参数  

Drug Concentration and Other Pharmacokinetic Parameters in Venous Blood and Blister Fluid of Patients with Extensive Burns at Different Time Points after Administration of Vancomycin

作　　者：郭培红 GUO Pei-hong(Pharmacy Department,Zhumadian Hospital of Traditional Chinese Medicine,Zhumadian Henan 463000,China)

机构地区：[1]驻马店市中医院药剂科,河南驻马店463000

出　　处：《抗感染药学》2022年第3期324-327,共4页Anti-infection Pharmacy

摘　　要：目的:探究大面积烧伤患者万古霉素给药后不同时间的静脉血和水疱液中的药物浓度及其他药动学参数。方法:选取2018年1月—2020年6月驻马店市中医院收治的46例烧伤面积大于50%患者作为研究对象,采用高效液相色谱法分析万古霉素用药前和第1次用药后0.5、1.0、2.0、4.0、8.0、12.0、24.0和48.0 h肘静脉血和水疱液中的药物浓度及其他药动学参数。结果:万古霉素用药后1 h时,其在血液和水疱液中药物浓度均达峰值;用药后0.5和1.0 h时,血液中万古霉素浓度高于水疱液(P<0.05);血液中万古霉素的分布相混杂参数(α)、消除相混杂参数(β)、药物从周边室向中央室转运的一级速率常数(K_(21))、药物从中央室消除的一级速率常数(K_(10))、药物从中央室向周边室转运的一级速率常数(K_(12))均大于水疱液(P<0.05),而其分布相半衰期(t_(1/2α))和消除相半衰期(t_(1/2β))短于水疱液,曲线下面积(AUC_(0~∝))小于水疱液,总清除率(CL_(s))大于水疱液(P<0.05);用药48 h后均无肾功能损伤和听力异常。结论:大面积烧伤患者早期使用万古霉素后水疱液中药物的半衰期长于血液中,其体内药动学参数的差异较大,临床应加强对其血药浓度的监测,根据患者药动学参数的变化调整给药剂量。Objective:To investigate the drug concentration and other pharmacokinetic parameters in venous blood and blister fluid of patients with extensive burns at different times after administration of vancomycin.Methods:Fortysix patients with a burn area greater than 50%who admitted to Zhumadian Hospital of Traditional Chinese Medicine from January 2018 to June 2020 were selected as research subjects.Drug concentration and other pharmacokinetic parameters in cubital venous blood and blister fluid before administration of vancomycin and at 0.5 h,1.0 h,2.0 h,4.0 h,8.0 h,12.0 h,24.0 h and 48.0 h after first administration of vancomycin were analyzed by HPLC method.Results:The drug concentrations of vancomycin in the blood and blister fluid reached the peak values at 1 hour after administration;the concentration of vancomycin in blood was higher than that in blister fluid at 0.5 h and 1.0 h after administration(P<0.05);the distribution phase confounding parameter(α),elimination phase confounding parameter(β),first-order rate constant for drug transport from peripheral to central compartment(K_(21)),and first-order rate constant for drug elimination from central compartment(K_(10)),and first-order rate constant for drug transport from the central to peripheral compartment(K_(12))of vancomycin in the blood were all greater than those of the blister fluid(P<0.05),while the half-life of the distribution phase(t_(1/2α))and the half-life of the elimination phase(t_(1/2β))of the blood were shorter than those of the blister fluid,the area under the curve(AUC_(0~∝))of the blood was smaller than that of the blister fluid,and the total clearance rate(CL_(s))in the blood was greater than that in the blister fluid(P<0.05);no renal function damage and hearing abnormalities occurred 48 hours after administration.Conclusion:The half-life of the drug in the blister fluid is longer than that in the blood after early administration of vancomycin in patients with extensive burns,and the in vivo pharmacokinetic parameters are quite diffe

关 键 词：大面积烧伤 万古霉素 药物浓度 药动学参数 

分 类 号：R969.1[医药卫生—药理学]