头孢吡肟在胰腺组织及胰液中的浓度测定及其临床意义

Determination of Cefepine concentrations in pancreatic tissue and juice and clinical significance

目的探讨头孢吡肟在胰腺外科中预防和治疗感染的效果。方法收集从2004年10月至2005年2月各类胰腺疾病手术患者20例，在静脉应用头孢吡肟后，测定血清、胰腺组织和胰液中头孢吡肟浓度。结果头孢毗肟在血清中的平均浓度为（2．23±0．24）μg／ml（0．23～4．66μg／ml），胰液中的平均浓度为（6．52±2．07）．g／ml，胰腺组织中的平均浓度为（10．93±1．52）μg／g；头孢吡肟在胰液中的浓度要高于血清中浓度（6．52μg／mlvs2．23μg／ml，P=0．046）。头孢吡肟在各种胰腺疾病之间的血清中浓度无差异（P〉0．05），但在慢性胰腺炎患者中头孢吡肟在胰液和胰腺组织中的浓度要大于其他疾病患者（P〈0．05）。结论头孢吡肟能有效地通过血胰屏障，对于胰腺疾病和胰腺手术患者可起到良好的预防和治疗感染效果。

Objective To investigate the effect of cefepime （Maxipimc） to prevent and treat infection in patients with pancreat is discard. Methods From Oct. 2004 to Feb. 2005, 20 patients with pancreatic diseases were admitted for treatment. After injection intravenously, the concentrations of cefepime （Maxipime） in plasma, pancreatic tissue and pancreatic juice were determined. Results The mean concentration levels of cefepime in plasma, pancreatic juice and pancreatic tissue were as follows： （2.23 ± 0.24）μg/ml（0.23-4.66 μg/ml）, （6.52 ± 2.07）μg/ml （0.14 - 35.34 μg/ml）, （ 10.93 ±1.52）μg/g（4.65-23.6μg/g）. The concentration level was higher in pancreatic juice than in plasma （6.52 μ/ml vs 2.23 μg/ml, P =0.046）. No significant difference was observed in plasma among different pancreatic diseatic（ P 〉0.05）. Significant difference was observed in the pancreatic juice and tissue between the patients with chronic pancreatitis and other pancreatic diseases（ P 〈 0.05 ）. Conclusion Cefepime （Maxipime） can penetrate the blood - pancreatic barrier efficiently and may have effects on prophylaxis and treatment of infection in patients with pancreatic diseases.