新生儿静脉滴注头孢呋辛的药物动力学

Cefuroxime pharmacokinetics in neonates

目的：对新生儿静脉滴注头孢呋辛进行药物动力学研究，了解该药在新生儿体内的代谢特点及对新生儿的脑膜通透性。方法：７名新生儿静脉滴注头孢呋辛２５ｍｇ／ｋｇ，进行药物动力学参数测定（取血１００μｌ）；８名化脓性脑膜炎新生儿静脉滴注后２ｈ取脑脊液（ＣＳＦ，５０μｌ），测定药物浓度。结果：静脉滴注后峰浓度达７５．２２±１２．９７ｍｇ／Ｌ，１２ｈ药物浓度为６．９５±１．７０ｍｇ／Ｌ，药物消除半衰期为３．７０±０．３７ｈ，表观分布容积为０．３４±０．０５Ｌ／ｋｇ，清除率为０．０７９±０．０１６Ｌ／（ｋｇｈ）。８名化脓性脑膜炎新生儿静滴后２ｈ脑脊液浓度为４．９５±２．８ｍｇ／Ｌ，为同期血浓度的１１％±６．１％。结论：头孢呋辛在新生儿体内维持有效浓度时间较长，脑膜通透性较强，适合新生儿抗感染使用。

OBJECTIVE:To study cefuroxime pharmacokinetics after single intravenous infusion and the cefuroxime permeability of meninx in neonates.METHOD:The pharmacokinetic parameters were determined after single intravenous infusion 25 mg/kg in 7 neonates and the cerebrospinal fluid(CSF) concentrations 2 hours after intravenous infusion in 8 purulence meningitis neonates.RESULTS:The peak concentration was 75.22±12.97 mg/L ,and the concentration 12 hours after infusion was 6.95±1.70 mg/L.The elimination T 1/2 was 3.70± 0.37 hours.The clerance of cefuroxime was 0.079±0.016 L/(kg·h),and the distribution volume was 0.34±0.05 L/kg .The CSF concentration 2 hours after infusion was 4.59±2.80 mg/L,and blood concentration 11%. CONCLUSION :Cefuroxime could maintain effective concentration for a long time in neonates and had good permeability through meninx.The dosage interval should be 12 hours for anti inflammatory treatment.