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目的 :对慢性阻塞性肺部疾病 (COPD)院内感染老年患者 qd iv gtt奈替米星 (NTM)的药物动力学及其在下呼吸道的分布进行研究 ,并观察临床疗效和不良反应。方法 :以尿素作为肺泡液稀释内标 ,用荧光偏振免疫法测定血清、支气管分泌液和肺泡液中 NTM浓度。结果 :NTM7m g/ kg qd iv gtt(30 min) ,血清 cmax(2 6 .71± 4.95 ) mg/ L,消除半衰期 3.96 h;肺泡液中cmax(7.76± 2 .13) mg/ L ,相当于血清 cmax的 2 9%。支气管分泌液药物浓度与血药浓度无相关性。 qd给药使肺泡中药物浓度超过常见肺炎致病菌的 MIC值。连续用药 7d,31例患者未见肝、肾、神经毒性。结论 :NTM qd iv gtt,由于给药间隔长 ,可适用于 COPD院内感染老年患者。
OBJECTIVE: To study the pharmacokinetics and its distribution in the lower respiratory tract of qd iv gtt netilmicin in elderly patients with chronic obstructive pulmonary disease (COPD) in hospital and to observe the clinical efficacy and adverse reactions. Methods: Using urea as alveolar fluid to dilute the internal standard, the concentration of NTM in serum, bronchial secretions and alveolar fluid were measured by fluorescence polarization immunoassay. Results: NTM7m g / kg qd iv gtt (30 min), serum cmax (26.71 ± 4.95) mg / L, elimination half-life of 3.96 h and cmax of alveolar fluid (7.76 ± 2.13) mg / Serum cmax 29%. Bronchial secretion drug concentration and plasma concentration had no correlation. qd administration of alveolar drugs in the concentration of more than common pathogens MIC of pneumonia. Continuous medication 7d, 31 patients no liver, kidney, neurotoxicity. Conclusion: NTM qd iv gtt, due to the long interval between administration, is suitable for COPD nosocomial infection in elderly patients.