目的 探究影响替考拉宁血药浓度的相关因素。方法 收集某院接受替考拉宁常规负荷剂量( 400 mg,q 12 h,3剂) 以及维持剂量(400 mg,qd)治疗的患者给药后第4天的血样,运用高效液相色谱法监测其替考拉宁谷浓度,统计分析血药浓度与相关生化指标的相关性。采用SPSS23.0对本试验数据进行多元线性回归分析。结果 共50例重症肺炎患者纳入本研究,替考拉宁平均稳态谷浓度为(9.367±4.989)μg·mL-1。多元线性回归结果显示,替考拉宁谷浓度剂量比(ρmin/Dose)与肌酐清除率和超敏C反应蛋白(hypersensitive-CRP,hs-CRP)成负相关(P=0.001)。结论 可以根据患者肌酐清除率和hs-CRP水平来调整替考拉宁的给药方案,从而更好地指导个体化用药。
Abstract
OBJECTIVE To investigate the related factors effecting the teicoplanin concentration..METHODS The patients′ information who accepted teicoplanin therapy and their plasma on the fourth day treatment were collected. The plasma was processed and detected by HPLC method. A multiple linear regression method was used to explore the relationship between the teicoplanin concentration and other factors. RESULTS The result of multiple linear regression shows that the teicoplanin concentration relates with the creatine clearance and hypersensitive C-reactive protein. CONCLUSION The teicoplanin treatment regimen could be altered by the level of patients′ creatine clearance and hypersensitive C-reactive protein in order to deliver a better individual treatment.
关键词
替考拉宁 /
血药浓度 /
肌酐清除率 /
超敏C反应蛋白
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Key words
teicoplanin /
plasma concentration /
creatine clearance /
hypersensitive C-reactive protein
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中图分类号：
R969.1
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参考文献
[1] JI C. Antibacterial activity and clinical application of teicoplanin [J]. World Notes Antibiot(国外医药:抗生素分册), 2001,22(3):27-29.
[2] CHEN Y, WANG S Y, HU G Y. Determination of teicoplanin in injection by bioassay[J]. Chin Pharm J(中国药学杂志), 2002,37(4):64-66.
[3] WILSON A, PETER R. Clinical pharmacokinetics of teicoplanin[J]. Clin Pharmacokinetics, 2000, 39(3):167-183.
[4] ROBERTS J A, STOVE V, WAELE J J, et al. Variability in protein binding of teicoplanin and achievement of therapeutic drug monitoring targets in critically ill patients: lessons from the DALI study[J]. Inter J Antimicrob Agents, 2014, 43(5):423-430.
[5] DENG J J, WEI W. Advances in analytical methods of teicoplanin, a glycopeptide antibiotic[J]. J Mil Surge Southwest China(西南军医), 2009,11(5):925-926.
[6] MATSUMOTO K, KANAZA W, WATANABE E, et al. Development of initial loading procedure for teicoplanin in critically ill patients with severe infections[J]. Bio Pharm Bull, 2013, 36(6):1024-1026.
[7] ZU Y N, ZHANG H, ZHOU L J, et al. Monitoring of drug concentrations of elderly patients with severe Gram-positive bacteria infections treated with different dosages of teicoplanin and assessment of curative effect[J].Chin J Nosocom(中华医院感染学杂志), 2016, 26(23):109-111.
[8] SHI X L, ZHOU L J. Analysis of 51 cases of teicoplanin administration under the guidance of blood drug concentration monitoring[J]. Chin Pharm Aff(中国药事), 2016, 30(8):96-99.
[9] YAMADA T, KUBOTA T, NAKAMURA M, et al. Evaluation of teicoplanin concentrations and safety analysis in neonates[J]. Inter J Antimicrobial Agents, 2014, 44(5):458-462.
[10] China National Prescription Collection and Editorial Committee. Chinese National Formulary Chemicals and Biological Products(抗菌药物临床应用指导原则)[M]. Beijing: People′s Military Medical Publishing House, 2010: 475.
[11] JIA H J, ZHENG X H, ZHAO Z Y. The interpretation of guidelines for clinical application of antibiotics(2015)[J]. Tianjin Pharm(天津药学),2016,28(5):46-48.
[12] SUN Z. Medical statistics[J]. Med Statist(医学统计学), 2002,24(29):253-257.
[13] BEGG E J, LBARCLA Y M, KIRKPATRICK C M. The therapeutic monitoring of antimicrobial agents[J]. Br J Clin Pharmacol, 2001, 52(suppl 1):35-43.
[14] FANOS V, KACET N, MOSCONI G. A review of teicoplanin in the treatment of serious neonatal infections[J]. Springer Verlag, 1997, 156(6):423-427.
[15] TAKASHI N, YOSHINORII M, TOMOFUMI O, et al. Significance of individual adjustment of initial loading dosage of teicoplanin based on population pharmacokinetics[J]. Inter J Antimicrob Agents, 2010, 35(5):507-510.
[16] HU S S, DONG Y L. Pharmacokinetics and administration regimen of teicoplanin in different populations[J]. Northwest Pharm J(西北药学杂志), 2009,24(3):232-234.
[17] ROWLAND M. Clinical pharmacokinetics of teicoplanin[J]. Clin Pharmacol, 1990, 18(3):184-209.
[18] SMITHERS-J A, THOMPSON-G A, KENNY-M T, et al. Applicability of teicoplanin dosage adjustment guidelines for renally impaired patients over the range of 3 to 30 mg·kg-1[J]. Biopharm Drug Dispos, 1992, 13(8):571-581.
[19] UHART M, LEROY B, MICHAUD A, et al. Variabilité pharmacociné tique inter-et intra-individuellelors de traitements par teicoplanine chez les sujets agés[J]. Med Mal Infect, 2013, 43(7):295-298.
[20] FEDERICO P, PIERLUIGI V, ANNA C, et al. Teicoplanin in patients with acute leukaemia and febrile neutropenia: a special population benefiting from higher dosages[J]. Clin Pharmacol, 2004, 43(6):405-415.
[21] ZHANG X H, LI G T, ZHANG Z L. Clinical significances of C-reactive protein and hypersensitive C-reactive protein[J]. Chin J Allerg Clin Immunol(中华临床免疫和变态反应杂志), 2011,5(1):74-79.
[22] SIERRA R, RELLO J, BAILÉN M, et al. C-reactive protein used as an early indicator of infection in patients with systemic inflammatory response syndrome[J]. Springer Verlag, 2004, 30(11):2038-2045.
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