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1、连续性静脉-静脉血液滤过患者血清中利奈唑胺的浓度监测杨华1,3,董海燕1,董亚琳1*1.西安交通大学医学院第一附属医院药学部,陕西西安710061;2.西安交通大学医学院第一附属医院中心ICU;3.西安市红十字会医院,陕西西安710054[摘要]目的:对连续性静脉-静脉血液滤过(continuousvenovenoushemofiltration,CVVH)治疗的危重患者进行利奈唑胺血药浓度监测,为临床个体化治疗提供依据。方法:建立高效液相色谱法(以左氧氟沙星为内标),测定患者血清中利奈唑胺谷浓度。结果:利奈唑胺在0.31~20.00mg·
2、ml-1内线性关系良好(r=0.9995),定量限为0.31mg·ml-1,方法回收率为99.12%。5例危重患者在治疗期间监测23次的利奈唑胺谷浓度变化明显,变化范围为1.53-17.10mg·ml-1。有2例患者谷浓度变化较大(相差近5倍)。结论:高效液相色谱法简单、快速、准确、灵敏、重现性好,可用于临床利奈唑胺的血药浓度监测。进行连续性静脉-静脉血液滤过治疗的患者,应用利奈唑胺时血药浓度变化较大,需要通过治疗药物监测的方法制定个体化给药方案。[关键词]利奈唑胺;高效液相色谱法;治疗药物监测;连续性静脉-静脉血液滤过;个体化治疗[中图分
3、类号]R978.1[文献标识码]A[文章编号]Determinationofserumlinezolidconcentrationincriticallyillpatientsduringcontinuousveno-venoushemofiltrationYANGHua1,3,DONGHai-yan1,YOUHai-sheng1,WANGXue2,LIHao2,DONGWei-hua1,DONGYa-lin1*(1.TheFirstAffiliatedHospital,SchoolofMedicine,Xi’anJiaotongUnive
4、rsity,ShanxiXi’an710061;2.TheFirstAffiliatedHospital,ICU,JiaotongUniversity,ShanxiXi’an710061;3.Xi’anRedCrossHospital,ShanxiXi’an710054)基金项目:西安交通大学医学院第一附属医院院基金(编号2008YK28)作者简介:杨华,硕士研究生,E-mail:flower100016@yahoo.com.cn通讯作者:董亚琳,博士,主任药师,电话:029-85323241,E-mail:dongyalin@mail.x
5、jtu.edu.cnAbstract:ObjectiveTomonitortheserumlinezolidtroughconcentrationincriticallyillpatientswithcontinuousvenovenoushemofiltration(CVVH),inordertomakeindividualizedtreatmentregimentforthesepatients.MethodsToestablishamethodofdeterminingserumlinezolidinhumanbyHPLC(inter
6、nalstandardmethod).ResultAgoodlinearitywasdemonstratedbetween0.31–20.00mg·ml-1(r=0.9995),thelowestlimitofquantificationof0.31mg·ml-1.Therelativerecoverywas99.12%.LinezolidserumconcentrationschangedsignificantlyinthefivepatientsduringCVVH,withthetroughconcentrationrangeof1.
7、53-17.10mg·ml-1.Thelinezolidtroughconcentrationintwopatientsshowedchanginggreatly(nearly5-fold).8ConclusionThemethodissimple,rapid,accurate,sensitive,reproducible,andvalidatedfordeterminationofserumlinezolidinpatients.Linezolidserumconcentrationsincriticallyillpatientsduri
8、ngcontinuousvenovenoushemofiltrationshowedsignificantvariability.Drugconcentrationshouldb