静脉注射后环丙沙星在人眼房水内的药物水平

Intraocular Ciprofloxacin Levels after Infusion Administration in Human Eyes

【目的】研究人类血-眼屏障正常情况下环丙沙星在眼房水内的药物水平。【方法】2006年8月至2007年2月在我院住院手术的老年性白内障病人45例(45眼),按2∶1随机分为实验组及对照组,实验组手术前1h静脉注射环丙沙星(200mg),两组术中取房水,用双缩脲法测定房水蛋白含量,反向高效液相色谱法测定房水环丙沙星浓度。【结果】白内障病人房水蛋白含量是(0.067±0.037)g/L,环丙沙星浓度是(0.172±0.060)μg/mL。【结论】老年性白内障病人血-房水屏障基本正常;血-眼屏障正常情况下,静脉注射环丙沙星房水中药物浓度不能达到大部分眼内致病菌90%菌株最小抑菌浓度,提示静脉注射环丙沙星不能单独作为白内障病人手术前预防性用药。

[Objective]To evaluate intraocular penetration of intravenously administered ciprofloxaein in the human eyes when blood-aqueous barriers are normal. [Methods]Thirty patients undergoing cataract surgery were perfused with ciprofloxacin （200 mg） prior to ocular surgery and another 15 patients as a control. Aqueous humor was collected at surgery in all eyes, and the protein concentration of aqueous humor was measured by biuret conorimetric method. Ciprofloxacin concentration of aqueous humor were assayed by high-performance liquid chromatograph （RP-HPCL） simultaneously.[Result]The protein concentration of aqueous humor in the patients with cataract was （0.067 ± 0.037）g/L,and the ciprofloxacin of aqueous humor in experimental group was （0.172 ±0.060）μg/mL. [Conclusion]The blood-aqueous barriers of the patients with cataract are basially normal. Ciprofloxacin level of aqueous humor after intravenous injection was below the minimum inhibitory concentration （MIC90） for most of the common microorganisms causing endophthalmitis in basially normal blood-aqueous barriers,so intravenously administered ciprofloxaein alone may not be adequate for perioperative prophylaxis.