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研究美洛培南用于严重烧伤患者早期的药代动力学。方法 11名烧伤休克期患者 (S组 )给药后 ,利用高效液相色谱分析技术测定其血浆、水疱液、尿液中美洛培南浓度 ,计算药代动力学参数 ;另选 6名健康志愿者为对照组 (C组 )。结果与C组相比。S组的药代动力学参数发生明显改变。表现为消除半衰期延长 :S组 ( 2 2 9± 0 5 4)h、C组 ( 1 3 4± 0 16)h ;肾清除滤降低 :S组( 11 3 4± 3 8)L·h-1 、C组 ( 18 76± 4 60 )L·h-1 。药浓 -时间曲线下面积增大 :S组 ( 4 7 85± 16 15 ) μg·h·ml-1 、C组 ( 2 7 5 4± 10 76)μg·h·ml-1 。静脉给予美洛培南后 6h的血药浓度为 ( 0 96± 0 5 3 μg/ml) ,已超过多数烧伤临床分离菌的MIC50 (≤ 0 2 5 μg/ml)。 结论 多数常见致病菌感染时用 5 0 0mg ,每 8h重复一次 ,就能达到有效的血液及创面浓度 ,不必加大剂量。若要给予大剂量美洛培南 ,应考虑因Vc的增大和T1/ 2 β延长可能导致的药物中毒 ,注意延长给药间隔时间 ,减少毒副反应
To study the early pharmacokinetics of meropenem in patients with severe burn. Methods Eleven burn shock patients (group S) were administered with high performance liquid chromatography (HPLC) to determine the concentration of meropenem in plasma, blister fluid and urine to calculate pharmacokinetic parameters. Another six healthy Volunteers for the control group (C group). Results compared with the C group. Pharmacokinetic parameters of S group changed obviously. (2 29 ± 0 5 4) h in group S and (1 3 4 ± 0 16) h in group C, and decreased renal clearance and filtration: group S (11 34 ± 3 8) L · h- 1, group C (18 76 ± 4 60) L · h-1. The area under the drug concentration-time curve increased: S group (4 7 85 ± 16 15) μg · h · ml-1 and C group (27 54 ± 10 76) μg · h · ml-1. The plasma concentration of 6 hours after intravenous meropenem (0 96 ± 0 5 3 μg / ml) exceeded the MIC50 (≤ 0 25 μg / ml) of most clinical isolates of burns. Conclusion Most of the common pathogenic bacteria infection with 500 mg, repeated every 8 h, you can achieve effective blood and wound concentration, without increasing the dose. To give a high dose of meropenem, consideration should be given to drug poisoning that may result from an increase in Vc and prolongation of T1 / 2 β. Note that prolonging the interval between administrations and reducing toxicity