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目的:建立T>MIC超过40%的美罗培南给药设计方案。方法:估算患者药动学参数,以T>MIC达到40%~100%为目标,利用药动学公式和简易数学法设计给药方案,比较实测Cmax、Cmin与预测值的差别,并分别计算药时曲线法和简易数学模拟法下的T>MIC。结果:患者预测Cmin为(1.6±0.9)μg·ml-1,实际Cmin为(1.8±1.6)μg·ml-1,预测Cmax为(23.2±8.8)μg·ml-1,实际Cmax为(26.8±13.3)μg·ml-1,预测Cmin、Cmax与实际Cmin、Cmax均具有相关性(P<0.001,r=0.695;P<0.001,r=0.874);患者药时曲线模拟法的T>MIC与简单数学模拟法的T>MIC具有高相关性(P<0.001,r=0.968),校正公式为:Y=1.116 X-12.28。30例患者中仅有2例的T>MIC没有达到目标范围。结论:本方案简便,快捷,可用于临床美罗培南个体化给药方案的设计及评价。
OBJECTIVE: To establish a meropenem dosing regimen with T> MIC over 40%. Methods: To estimate the pharmacokinetic parameters of patients, with the target of T> MIC reaching 40% ~ 100%, the dosing regimen was designed by pharmacokinetic formula and simple mathematical method, and the difference between measured Cmax and Cmin was compared with the predicted value T> MIC under the time curve of medicine and simple mathematical simulation. Results: The predicted Cmin was (1.6 ± 0.9) μg · ml-1, the actual Cmin was (1.8 ± 1.6) μg · ml-1 and the predicted Cmax was (23.2 ± 8.8) μg · ml-1. The actual Cmax was (26.8 ± 13.3) μg · ml-1, respectively. The predicted Cmin and Cmax were correlated with the actual Cmin and Cmax (P <0.001, r = 0.695, P <0.001, r = 0.874) (P <0.001, r = 0.968), the correction formula was: Y = 1.116 X-12.28.T> MIC of only 2 out of 30 patients did not reach the target range . Conclusion: The scheme is simple and quick, and can be used in the design and evaluation of clinical meropenem individualized dosing regimen.