CAJ | 학술논문

目的：建立液相色谱-串联质谱法（LC-MS/MS）测定连续肾脏替代治疗（continuous renal replacement therapy， CRRT）患者血浆及超滤液中头孢哌酮与舒巴坦浓度。方法以头孢呋辛酯为内标，采用WatersAtlantis dC18色谱柱（150 mm×4.6 mm，5.0μm）进行分离，通过串联质谱仪，以多反应监测方式进行测定。用于定量分析的离子对分别是m/z 644.1→528.1（头孢哌酮）、m/z 231.8→188.0（舒巴坦）和m/z 509.3→206.9〔头孢呋辛酯，内标（IS）〕。结果头孢哌酮在10~500μg/ml范围内，舒巴坦在6~300μg/ml范围内线性关系良好。提取回收率＞90.0%，日内和日间相对标准偏差均＜15%。血浆和超滤液的基质效应结果表明，两种介质的基质对头孢哌酮、舒巴坦和IS的测定影响较小。结论本方法简便、快捷、灵敏度高，可在同一样品中同时检测两种药物，适用于危重患者行CRRT时血药浓度、超滤液药物浓度的监测，计算筛选系数（sieving coefficient，Sc），为剂量调整提供准确依据。
목적：건립액상색보-천련질보법（LC-MS/MS）측정련속신장체대치료（continuous renal replacement therapy， CRRT）환자혈장급초려액중두포고동여서파탄농도。방법이두포부신지위내표，채용WatersAtlantis dC18색보주（150 mm×4.6 mm，5.0μm）진행분리，통과천련질보의，이다반응감측방식진행측정。용우정량분석적리자대분별시m/z 644.1→528.1（두포고동）、m/z 231.8→188.0（서파탄）화m/z 509.3→206.9〔두포부신지，내표（IS）〕。결과두포고동재10~500μg/ml범위내，서파탄재6~300μg/ml범위내선성관계량호。제취회수솔＞90.0%，일내화일간상대표준편차균＜15%。혈장화초려액적기질효응결과표명，량충개질적기질대두포고동、서파탄화IS적측정영향교소。결론본방법간편、쾌첩、령민도고，가재동일양품중동시검측량충약물，괄용우위중환자행CRRT시혈약농도、초려액약물농도적감측，계산사선계수（sieving coefficient，Sc），위제량조정제공준학의거。
Objective To establish a sensitiv e and specific LC-MS/MS method for the simultaneous determination of cefoperazone and sulbactam in plasma and ultrafiltrate of patients undergone continuous renal replacement therapy(CRRT). Methods Cefuroxime axetil was used as the internal standard,the plasma samples were separated on an WatersAtlantis dC18 column (150 mm× 4.6 mm, 5.0 μm). A tandem mass spectrometer equipped with ESI was used as the detector and operated in the mode of multiple reaction monitoring.Quantitive analysis of[M-H]-ions were m/z 644.1→528.1(cefoperazone), m/z 231.8→188.0(sulbactam) and m/z 509.3→206.9(the internal standard, IS), respectively. Results The linear range of cefoperazone and sulbactam in human plasma and ultrafiltrate were(10-500) and(6-300)μg/ml, respectively. Extraction recoveries were more than 90.0%, and intra- and inter-day relative standard deviation was less than 15%. The matrix effect of plasma and ultrafiltrate showed that the matrix effect of the two media had little influence on the measurement of cefoperazone, sulbactam and IS. Conclusion The method is simple, fast, and highly sensitive. The two drugs can be detected simultaneously in the same sample. It is appropriate to monitor drug concentration in plasma and ultrafiltrate of the patients undergone CRRT. Sieving coefficient could be calculated and provide an accurate basis for dose adjustment.