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1、危重症感染患者血清中利奈唑胺浓度监测aa*baba董海燕,董亚琳,王雪,杨华,李昊,刘娟娟(西安交通大学医学院第一附属医院,a药学部;b中心ICU,西安710061)摘要:目的监测ICU危重症感染患者利奈唑胺血清药物浓度。方法采用高效液相色谱法监测7例危重感染患者血清利奈唑胺浓度。结果对7例使用利奈唑胺的危重感染患者的34份样本进行了血清药物浓度监测,其中包括5例连续性静脉-1静脉血液滤过治疗的患者。7例患者治疗期间利奈唑胺浓度变化明显,平均谷浓度变化范围为127~759mgL,病原体-1-1最低抑菌浓度为2mgL,有1例患者利奈唑胺平均谷浓度(127mgL)小
2、于最低抑菌浓度,2例患者谷浓度变化较大-1(相差近10倍),1例患者虽然药物谷值浓度(759mgL)高于最低抑菌浓度,但感染持续存在,临床治疗结果为无效。结论危重症感染患者应用利奈唑胺后血药浓度变化较大,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;危重症患者;血清药物浓度中图分类号:R96911文献标志码:A文章编号:1001-2494(2010)16-1255-04TherapyDrugMonitoringofLinezolidinSerumofCriticallyIllPatientsaa*babaDONGHaiyan,DONGYalin
3、,WANGXue,YANGHua,LIHao,LIUJuanjuan(aDepartmentofPharmacy;bDepartmentofCentralICU,TheFirstAffiliatedHospital,MedicalCollege,XianJiaotongUniversity,Xian710061,China)ABSTRACT:OBJECTIVEToinvestigateserumlinezolidconcentrationincriticallyinfectiouspatientsinICUMETHODSLinezolidconcentrationsi
4、nserumweremonitoredinsevencriticalpatientsbyHPLCRESULTS34linezolidserumsampleswereanalyzedincriticalpatients,including5patientsundergoingcontinuousvenovenoushaemofiltration(CVVH)Linezolidserumconcentrationschangedsignificantlyinthesevenpatientsduringthetreatment,withtheaveragetroughconcentr
5、ationrangeof127-759mgL-1Theminimuminhibitoryconcentrationwas2mgL-1Thelinezolidtroughconcentration(127mgL-1)inonepatientwasbelowtheminimuminhibitoryconcentration,andanotherpatientshowedunexpectedtroughconcentrationfluctuation(nearly10fold)-1Theclinicaloutcomeofonepatients,althoughhistro
6、ughconcentrations(759mgL)wereaboveminimuminhibitoryconcentrations,wasfailureCONCLUSIONLinezolidserumconcentrationsincriticallyillpatientsshowssignificantvariability,andserumdrugconcentrationshouldbemonitoredinthesekindspatientsinordertodecideindividualdosageregimenoflinezolidinclinicalprac
7、ticeKEYWORDS:linezolid;criticallyillpatients;serumdrugconcentration[3]在重症监护病房(intensivecareuni,tICU),多MIC)的时间有关,国外有报道,当整个给药间期重耐药革兰阳性菌引起的院内感染是导致危重患者的药物浓度都保持在MIC以上时可以获得较高的感染发病率增高、死亡率增加、住院时间延长的重要成功率,即利奈唑胺的有效谷浓度保持在MIC以上[1]因素之
