CAJ | 학술논문

目的了解抗生素治疗过程中,严重烧伤患者血浆内毒素水平的变化. 方法选择50例烧伤面积大于30%TBSA的患者,分别应用临床上常见抗生素[分为奈替米星、头孢哌酮、头孢他啶、亚胺培南/西司他丁(业胺培南)组]常规治疗.采用偶氮基质显色法,检测抗生素治疗前后患者血浆内毒素水平. 结果奈替米星、头孢哌酮和头孢他啶组患者给药后,血浆内毒素水平有不同程度升高.其中头孢哌酮组先升高后下降,用药后第1、2天明显高于第3、5、7天(P＜0.05),同时明显高于亚胺培南组(P＜0.05).头孢他啶组用药后第5天内毒素水平达高峰(0.398±0.172)EU/mL,明显高于用药前[(0.251±0.142)EU/mL,P＜0.05],也明显高于奈替米星组、头孢哌酮组和亚胺培南组(P＜0.05).亚胺培南组用药后第1、2天血浆内毒素水平明显低于用药前. 结论不同抗生素治疗严重烧伤患者可诱导不等量的内毒素释放,临床用药应注意药物本身对内毒素水平的影响.
목적 료해항생소치료과정중,엄중소상환자혈장내독소수평적변화. 방법선택50례소상면적대우30%TBSA적환자,분별응용림상상상견항생소[분위내체미성、두포고동、두포타정、아알배남/서사타정(업알배남)조]상규치료.채용우담기질현색법,검측항생소치료전후환자혈장내독소수평. 결과내체미성、두포고동화두포타정조환자급약후,혈장내독소수평유불동정도승고.기중두포고동조선승고후하강,용약후제1、2천명현고우제3、5、7천(P＜0.05),동시명현고우아알배남조(P＜0.05).두포타정조용약후제5천내독소수평체고봉(0.398±0.172)EU/mL,명현고우용약전[(0.251±0.142)EU/mL,P＜0.05],야명현고우내체미성조、두포고동조화아알배남조(P＜0.05).아알배남조용약후제1、2천혈장내독소수평명현저우용약전. 결론불동항생소치료엄중소상환자가유도불등량적내독소석방,림상용약응주의약물본신대내독소수평적영향.
Objective To investigate the changes in the plasma levels of endotoxin in severe burn patients during administration of antibiotics. Methods Fifty severe burn patients with burn area larger than 30%TBSA were enrolled in the study,and they were respectively treated with Netilmicin(A group),Cefoperazone(B group),Ceftazidime(C group)and Imipenem/Cilastatin(D group).Venous blood samples were harvested for determination of endotoxins levels before treatment and 1,2,3,5,7 post-treatment day (PTD) Results The plasma levels of endotoxin were elevated in different degrees in A,B and C groups.The olasma levels of endotoxin in B group were higher on 1,2 PTD than on 3,5,7 PTD,and they were also higher than that in D group(P＜0.05).The plasma levels of endotoxin in C group reached the peak on 5PTD[(0.398±0.172)EU/mL],which were higher than that before treatment[(0.251±0.142)EU/mL,P<0.05]and other groups(P＜0.05).The plasma levels of endotoxin in D group were lower on 1,2 PTD than that before treatment(P＜0.05). Conclusion Different amounts of endotoxins can be released after treatment with antibiotics in severe burn patients. Attention should be paid to the effect of antibiotics on the levels of endotoxin in practice.