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目的 :了解阑尾炎患者静脉输注奈替米星后阑尾组织中药物处置及有效浓度。方法 :术前随机给予急诊患者 0 .3 g单剂量奈替米星输注 ,术中采集血清及阑尾组织标本用TDx测定药物浓度 ,计算血清及组织PK和动态组织穿透比、通透指数(PI)及抑制系数 (IQ ,cmax组织/MIC)。结果 :输注后奈替米星迅速进入阑尾组织 (无tlag,ka=1 .5788h- 1)并维持较高浓度 ;组织中药物呈一级吸收一级消除二室开放模型 ,血清及组织t1/ 2 β分别为 2 .1 2h和 2 .77h(P >0 .0 5) ;其阑尾组织PI为 0 .3 96,对应阑尾炎症组织常见致病菌IQ值大多数达到或大于 1 0。结论 :奈替米星在阑尾炎症组织具较高浓度 ,其组织消除基本与血清平行 ;每日 0 .3 g单剂量 3 0min静脉输注可满足阑尾组织中治疗浓度。
Objective: To understand the drug treatment and effective concentration of appendix in patients with appendicitis after intravenous infusion of netilmicin. Methods: The patients were given a single dose of netilmicin at a dose of 0.3 g before operation. Serum and appendix tissue samples were collected during operation. TDx was used to determine the drug concentration. PK and dynamic tissue penetration ratio of serum and tissue were calculated. (PI) and inhibition coefficient (IQ, cmax tissue / MIC). Results: The netilmicin rapidly entered the appendix tissue (no tlag, ka = 1.5788 h-1) after infusion, and maintained a higher concentration. The drug in the tissue showed a first-order absorption to eliminate the two-compartment open model and the serum and tissue t1 / 2 β were 2.12h and 2.77h, respectively (P> 0.05). The appendix tissue PI was 0.396, corresponding to the majority or more of the common pathogenic bacteria in appendicitis tissues. Conclusion: The netilmicin in appendicitis tissue with higher concentration, the elimination of its basic and serum parallel; daily 0.3 g single dose of 30 min intravenous infusion to meet the treatment of appendix tissue concentration.