利奈唑胺血药浓度与感染患者肝、肾功能的相关性  

Correlation Between Blood Drug Concentration of Linezolid and Liver and Kidney Function in Patients with Infection

作　　者：赵艳 盛雪鹤 伍葵[2] ZHAO Yan;SHENG Xuehe;WU Kui(The Second Affiliated Hospital of Southern Anhui Medical College,Wuhu,Anhui,China 241000;Wuhu Second People's Hospital,Wuhu,Anhui,China 241000)

机构地区：[1]皖南医学院第二附属医院,安徽芜湖241000 [2]安徽省芜湖市第二人民医院,安徽芜湖241000

出　　处：《中国药业》2023年第17期49-52,共4页China Pharmaceuticals

基　　金：皖南医学院中青年科研基金项目[WK2018F38]。

摘　　要：目的探讨感染患者肝、肾功能对利奈唑胺血药浓度的影响。方法回顾性分析皖南医学院第二附属医院2016年1月至2021年8月应用利奈唑胺的74例感染患者的临床资料,根据肝、肾功能指标分为正常组(23例)、肝功能不全组(20例)、肾功能不全组(31例),以丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、血肌酐(SCr)、尿素氮(BUN)水平评估肝、肾功能,分析患者治疗后血药谷浓度变化及其对肝、肾功能的影响,并统计不同血药谷浓度患者的痊愈例数。结果正常组患者治疗后的利奈唑胺血药谷浓度显著低于肝、肾功能不全组(P<0.05)。74例患者共监测78例次利奈唑胺血药浓度,其中血药谷浓度<2 mg/L 2例次(2.56%),2~7 mg/L 51例次(65.38%),>7 mg/L 25例次(32.05%)。血药谷浓度>7 mg/L时,患者治疗后的ALT,AST,SCr,BUN水平均较血药谷浓度2~7 mg/L时显著升高(P<0.05),但各组患者治疗前后的ALT,AST,SCr,BUN水平均无显著差异(P>0.05)。血药谷浓度<2 mg/L、2~7 mg/L、>7 mg/L患者分别痊愈0例、46例(62.16%)、23例(31.08%)。结论肝、肾功能不全患者应用利奈唑胺时应监测血药浓度,避免高血药浓度暴露引起的药品不良反应。Objective To investigate the effect of liver and kidney function on the blood drug concentration of linezolid in patients with infection.Methods The clinical data of 74 patients with infection who were treated with linezolid in the Second Affiliated Hospital of Southern Anhui Medical College from January 2016 to August 2021 were retrospectively analyzed,and they were divided into the normal group(23 cases),the hepatic insufficiency group(20 cases),and the renal insufficiency group(31 cases)according to their liver and renal function indexes.The liver and kidney functions were evaluated by the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum creatinine(SCr)and blood urea nitrogen(BUN),the changes in trough blood concentration and its effect on liver and kidney function before and after treatment were analyzed,and the number of recovery cases in patients with different blood drug trough concentrations was counted.Results After treatment,the linezolid trough blood concentration in the normal group was significantly lower than that in the hepatic insufficiency group and renal insufficiency group(P<0.05).A total of 74 patients were monitored for 78 times of linezolid blood concentration,of which two cases(2.56%)had a trough blood concentration of<2 mg/L,51 cases(65.38%)had a trough blood concentration of 2-7 mg/L,and 25 cases(32.05%)had a trough blood concentration>7 mg/L.The levels of ALT,AST,SCr,and BUN before and after treatment in the patients with trough blood concentration of>7 mg/L were significantly higher than those in patients with trough blood concentration of 2-7 mg/L(P<0.05),but there were no significant differences in the levels of ALT,AST,SCr,and BUN before and after treatment in each group(P>0.05).In patients with trough blood concentration of<2 mg/L,2-7 mg/L,>7 mg/L,there were 0 case,46 cases(62.16%),and 23 cases(31.08%)of infection recovery,respectively.Conclusion The blood drug concentration of linezolid should be monitored in patients with hepatic and renal insufficienc

关 键 词：利奈唑胺 血药谷浓度 肝功能 肾功能 治疗药物监测 

分 类 号：R969.4[医药卫生—药理学] R978.1[医药卫生—药学]