目的:观察在全胃肠外营养(TPN)时患者体内奈替米星(乙基西梭霉素,NTM)的药代动力学?方法:用高效液相-间接光度检测法(HPLC-IPD)测定7例行TPN患者和7例对照患者静滴NTM5mg·kg^-1后血清和尿中药物浓度,并计算药代动力学参数?结果:NTM在体内处置符合二室开放模型,静滴后TPN组NTM血清峰浓度低于对照组但无显著性差异,至5h后TPN组浓度开始高于对照组,至12h时已明显高于对照组;尿中原型药物排出率TPN组较对照组下降,但无显著性差异;TPN组与对照组血清NTM的t_1/2β分别为(5.8±1.6)h和(3.5±1.4)h?结论:患者给TPN时,NTM体内分布和消除变慢。

OBJECTIVE:To study the effects of total parenteral nutrition (TPN) on the pharmacoknetics of netilmicin (NTM) in patients.METHODS:Seven patients with intestines fistula under TPN and seven control patients received 5mg·kg^-1 NTM by iv infusion in 0.5h.NTM concentrations in serum and urine were determined by a high-performance liquid chromatography-indirect photometric determination (HPLC-IPD) method.Pharmacokinetic parameters were calculated with a PKPB-NI program.RESULTS:After intravenous administration of NTM 5mg·kg^-1,the NTM peak concentration in serum was not significantly lower in the TPN group than the control group(P>0.05),but the NTM level of the TPN group was higher than control (P>0.05) at 5h after administration and significantly higher at 12h (P<0.05).The excretion of parental NTM in urine were (52±13)% in the TPN group and (63±15)% in the control.The pharmacokinetics of NTM were disposed in a two-compartment open model with t_1/2β=(5.8±1.6)h and V_c=(0.47±0.15)L·kg^-1 in the TPN group,t_1/2β=(3.5±1.4)h and V_c=(0.28±0.09)L·kg^-1 in control,respectively.CONCLUSION:The results suggested that there would be a marked drop in the distribution and elimination of NTM in the patients under TPN.