伊米配能在烧伤急性期的药代动力学研究  

Study on the pharmacokinetics of Imipenem cilastatin in burn patients during the acute phase.

作　　者：王慧敏[1] 彭毅志[2] 肖光夏[2] 

机构地区：[1]成都军区总医院护理部,610083 [2]第三军医大学西南医院烧伤研究所,重庆400038

出　　处：《中华烧伤杂志》2000年第6期349-351,共3页Chinese Journal of Burns

基　　金：全军"九五"指令性课题 !(96L0 42 )

摘　　要：目的　研究伊米配能 /西司他丁在烧伤急性期患者应用时的药代动力学特点。　方法　 6名烧伤急性期患者 (P组 )第一次给药后 ,利用高效液相色谱分析技术测定其血浆、水疱液、痂下组织、尿液中伊米配能浓度 ,计算药代动力学参数 ;另选 10名健康志愿者为对照组 (C组 )。结果同C组相比 ,P组的药代动力学参数发生明显改变。表现为半衰期延长 :C组 (1.0 6± 0 .2 4)h、P组 (1.5 6±0 .5 5 )h ;分布容积增大 :C组 (13.96± 7.10 )、P组 (16 .16± 4.2 6 )。第一次给药后 1h即能测出P组水疱液和痂下组织中伊米配能浓度 ,分别为 (8.17± 1.6 9) μg/ml、(12 .14± 2 .72 ) μg/g。伊米配能的肾清除率与患者肌酐清除率呈正相关 (r =0 .5 834)。　结论　急性期应用负荷剂量的伊米配能 /西司他丁时应延长用药间隔时间 ;早期应用伊米配能 /西司他丁可穿透II度、III度烧伤组织 ;Objective To investigate the pharmacokinetic characteristics of lmipenem /cilastatin in burn patients during the acute phase. Methods Imipenem conentrations in the plasma,blister and,interstitial fluids and urine of 6 burn patients (P group) were determined during the acute phase by high performance liquid chromatography after the first initial dose.Pharmacokinetic parameters were thus produced and statistically analyzed by program package STAT 5.Ten healthy volunteers served as control group (C group). Results Compared to those in control group,pharmacokinetic parameters of Imipenem exhibited evident difference,such as prolonged half-life[(1.56±0.55)h vs (1.06±0.24)h ]and enlarged distributing volume(16.16±4.26)vs(13.96±7.10).Imipenem could be detected in the blister and interstitial fluids of burn patients 1 hr after the initial dose.Renal clearance of Imipenem was positively correlated to creatinine clearance(r=0.5834). Conclusion The intervals between doses should better be prolonged when loaded-dosage of lmipenem was administered in burn patients during the acute phase. Imipenem could penetrate Ⅱand Ⅲ degree burn wound when given in the acute phase.Attention should be paid to renal function when Imipenem was given.

关 键 词：烧伤 急性期 伊米配能 药物代谢动力学 抗生素 

分 类 号：R644[医药卫生—外科学] R978.1[医药卫生—临床医学]