CAJ | 학술논문

目的：研究左旋氧氟沙星口服后在肝硬化患者血清和腹水中的分布及动态变化，评价该药对肝硬化并发原发性细菌性腹膜炎(SBP)的疗效。方法：收集7例肝硬化合并腹水患者口服左旋氧氟沙星300 mg后不同时间点的血清（0.5、1、1.5、2、12 h）和腹水（2、4、6、12 h）标本，采用高效液相法检测其中药物浓度并观察其动态变化；对30例肝硬化并发SBP患者予左旋氧氟沙星300 mg 口服， 2次/d，连续7～14 d，进行疗效评价。结果：各个时间点的血清和腹水标本中均可测出药物浓度并随给药时间呈动态变化，血清中达高峰浓度时间tmax 约1.5 h，高峰浓度cmax(3.913±1.388) μg/ml，腹水中tmax 约6 h 迟于血清，cmax (2.520±1.213) μg/ml，低于血清。血清和腹水中药物浓度达到高峰后随时间推移而逐渐下降，至12 h两者趋于稳定。并发SBP患者经治疗后发热、腹部体征、腹水性状和外周血象均有明显改善，未见明显药物毒性及不良反应。结论：左旋氧氟沙星口服后在患者的血清和腹水中均有分布并可形成高峰浓度，有效药物浓度持续时间长达12 h以上；治疗SBP特别是对轻中度患者疗效明显，并具有口服吸收好、给药次数少、无明显毒性及不良反应的优点。
목적：연구좌선양불사성구복후재간경화환자혈청화복수중적분포급동태변화，평개해약대간경화병발원발성세균성복막염(SBP)적료효。방법：수집7례간경화합병복수환자구복좌선양불사성300 mg후불동시간점적혈청（0.5、1、1.5、2、12 h）화복수（2、4、6、12 h）표본，채용고효액상법검측기중약물농도병관찰기동태변화；대30례간경화병발SBP환자여좌선양불사성300 mg 구복， 2차/d，련속7～14 d，진행료효평개。결과：각개시간점적혈청화복수표본중균가측출약물농도병수급약시간정동태변화，혈청중체고봉농도시간tmax 약1.5 h，고봉농도cmax(3.913±1.388) μg/ml，복수중tmax 약6 h 지우혈청，cmax (2.520±1.213) μg/ml，저우혈청。혈청화복수중약물농도체도고봉후수시간추이이축점하강，지12 h량자추우은정。병발SBP환자경치료후발열、복부체정、복수성상화외주혈상균유명현개선，미견명현약물독성급불량반응。결론：좌선양불사성구복후재환자적혈청화복수중균유분포병가형성고봉농도，유효약물농도지속시간장체12 h이상；치료SBP특별시대경중도환자료효명현，병구유구복흡수호、급약차수소、무명현독성급불량반응적우점。
Objective: To study the distribution of levofloxacin in the serum and ascites in patients with cirrhosis and to evaluate its efficacy in treatment of patients with spontaneous bacterial peritonitis(SBP). Methods:（1）Concentration of levofloxacin in the serum and ascites was detected with HPLC in 7 patients with cirrhosis at different time (in the serum: 0.5, 1, 1.5, 2 and 12 h;in the ascites:2, 4, 6 and 12 h). （2）The effects of levofloxacin were observed in treatment of 30 patients with SBP. Results:（1） Levofloxacin was determined in serum and ascites of patients with cirrhosis, whose concentration depended on the duration after oral administration. In serum: tmax was 1.5 h and cmax was (3.913±1.388) μg/ml. In ascites: tmax was 6.0 h and cmax was (2.520±1.213) μg/ml. The levels decreased gradually after reaching peak concentration, then stabilized from 12 h.（2）The symptoms and signs were significantly improved in patients with SBP treated with the levofloxacin. Conclusion: After the oral administration, levofloxacin can both distribute in serum and ascites, and it is efficient in the treatment of the patients with SBP.