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第三代头孢霉素——头孢曲松(ceftriaxcone)有广谱及强有力的抗菌活力,且血浆半衰期长,已被广为采用。本药主要经尿排泄,20～40％经胆汁排泄。有报道,长期大剂量应用可导致胆泥暂时产生,超声下表现类似胆囊结石,但停用本药后超声异常表现很快消失。其发生机制和化学成分还不甚了解。为此,本研究观察胆囊沉淀物的肉眼和镜下特征,并作化学分析。材料和方法:4例非胆石症患者因接受头孢曲松治疗出现胆泥而行胆囊切除术,收集胆囊内容物。用光学显微镜、相差显微镜、偏振显微镜观察沉淀物。扫描电镜(SEM)研究晶体结构。用电子微探针分析法作元素分析和红外线光谱分析,并取上清液分别作高性能液相色谱法(HPLG)和薄层层析法(TLG)分析。
The third generation of ceftriaxone - ceftriaxone (ceftriaxone) has a broad spectrum and strong antibacterial activity, and the long half-life of plasma has been widely used. The main excretion of urine by the drug, 20 to 40% by bile excretion. It has been reported that long-term high-dose application can cause temporary production of bile sludge, ultrasound-like gallbladder stones under the performance, but the suspension of the drug ultrasound abnormalities disappeared quickly. Its mechanism and chemical composition are not well understood. To this end, the study observed gallbladder sediment macroscopic and microscopic features, and for chemical analysis. Materials and Methods: In 4 patients with non-cholelithiasis who underwent cholecystolithotomy due to bile sludge under ceftriaxone treatment, the gallbladder contents were collected. The precipitate was observed with an optical microscope, a phase contrast microscope and a polarization microscope. Scanning electron microscopy (SEM) studies the crystal structure. Electron microprobe analysis was used for elemental analysis and infrared spectroscopy, and the supernatant was analyzed by high performance liquid chromatography (HPLG) and thin layer chromatography (TLG).