河北医药
河北醫藥
하북의약
HEBEI MEDICAL JOURNAL
2015年
8期
1148-1151
,共4页
静脉给药%奈替米星%肺疾病,阻塞性%临床效果%药动学
靜脈給藥%奈替米星%肺疾病,阻塞性%臨床效果%藥動學
정맥급약%내체미성%폐질병,조새성%림상효과%약동학
intravenously guttae administration%netilmicin%pulmonary disease,obstructive%clinical effect%pharmacokinetic
目的：研究老年慢性阻塞性肺部疾病（ COPD）患者奈替米星（ NTM）静脉滴注给药在下呼吸道的分布和药物动力学，并分析其临床疗效和不良反应。方法24例COPD患者分为A、B组，每组12例。2组NTM剂量分别为A组每天7=．0 mg／kg，B组给予5．0 mg／kg，静脉滴注。利用荧光偏振免疫方法，使用尿素替代肺泡液稀释内标，测定肺泡液、支气管分泌液和血清中的NTM浓度。结果 A组药物动力学参数表现为，血清中NTM最高浓度Cmax可达（26．73±4．96）mg／L，消除半衰期为3．95 h；肺泡液中最高浓度为（7．75±2．12）mg／L，是血清Cmax的30％，而支气管分泌液中药物的浓度与肺泡液浓度呈正相关（ r ＝0．6434， P ＜0．05）。采用静脉滴注给药方式，肺泡中的药物浓度比常见肺炎致病菌的MIC值高。连续给药7 d后，所有患者均未见神经、肝、肾毒性。结论静脉滴注给药方式，给药间隔时间长，且不会增加不良反应，更适用于临床上老年COPD患者的治疗。
目的：研究老年慢性阻塞性肺部疾病（ COPD）患者奈替米星（ NTM）靜脈滴註給藥在下呼吸道的分佈和藥物動力學，併分析其臨床療效和不良反應。方法24例COPD患者分為A、B組，每組12例。2組NTM劑量分彆為A組每天7=．0 mg／kg，B組給予5．0 mg／kg，靜脈滴註。利用熒光偏振免疫方法，使用尿素替代肺泡液稀釋內標，測定肺泡液、支氣管分泌液和血清中的NTM濃度。結果 A組藥物動力學參數錶現為，血清中NTM最高濃度Cmax可達（26．73±4．96）mg／L，消除半衰期為3．95 h；肺泡液中最高濃度為（7．75±2．12）mg／L，是血清Cmax的30％，而支氣管分泌液中藥物的濃度與肺泡液濃度呈正相關（ r ＝0．6434， P ＜0．05）。採用靜脈滴註給藥方式，肺泡中的藥物濃度比常見肺炎緻病菌的MIC值高。連續給藥7 d後，所有患者均未見神經、肝、腎毒性。結論靜脈滴註給藥方式，給藥間隔時間長，且不會增加不良反應，更適用于臨床上老年COPD患者的治療。
목적：연구노년만성조새성폐부질병（ COPD）환자내체미성（ NTM）정맥적주급약재하호흡도적분포화약물동역학，병분석기림상료효화불량반응。방법24례COPD환자분위A、B조，매조12례。2조NTM제량분별위A조매천7=．0 mg／kg，B조급여5．0 mg／kg，정맥적주。이용형광편진면역방법，사용뇨소체대폐포액희석내표，측정폐포액、지기관분비액화혈청중적NTM농도。결과 A조약물동역학삼수표현위，혈청중NTM최고농도Cmax가체（26．73±4．96）mg／L，소제반쇠기위3．95 h；폐포액중최고농도위（7．75±2．12）mg／L，시혈청Cmax적30％，이지기관분비액중약물적농도여폐포액농도정정상관（ r ＝0．6434， P ＜0．05）。채용정맥적주급약방식，폐포중적약물농도비상견폐염치병균적MIC치고。련속급약7 d후，소유환자균미견신경、간、신독성。결론정맥적주급약방식，급약간격시간장，차불회증가불량반응，경괄용우림상상노년COPD환자적치료。
Objective To investigate the distribution and pharmacokinetics of ) netilmicin ( NTM ) in lower respiratory tract of elderly patients with chronic obstructive pulmonary disease ( COPD ) by means of intravenously guttae administration ( iv gtt) ,and to analyze its therapeutic effect and adverse reactions.Methods The concentrations of NTM in bronchial secretions,pulmonary alveolus solution and serum were detected by fluorescence polarization immunoassay ( FPIA) , using urea as diluted internal standard instead of pulmonary alveolus solution.Results The pharmacokinetic parameters in patents who received intravenously guttae with netilmicin 7.0mg/kg were as follows: the maximum concentration ( Cmax) of NTM was (26.73 ±4.96)mg/L,elimination half life was 3.95h,the maximum concentration of NTM in pulmonary alveolus solution was (7.75 ±2.12) mg/L,which was equal to 30%of serum Cmax.However there was no correlation between the drug concentration in bronchial secretions and blood drug level.The drug concentration in pulmonary alveoli was higher than MIC value of common pathogen of pneumonia by means of intravenously guttae administration.The toxicities of nerve, liver and kidney were not found in all the patients after successive administration for 7 days.Conclusion The intravenously guttae way is more suitable for the treatment of COPD in elderly patients,with longer dosing interval,without increasing side effects.
