美罗培南在连续性肾脏替代治疗患者中的药代动力学

Pharmacokinetics of meropenem in patients with continuous renal replacement therapy

目的研究美罗培南(碳青霉烯类抗生素)在连续性肾脏替代治疗(CRRT)患者的药代动力学特点。方法10名CRRT患者在30 min内匀速静滴美罗培南1.0 g,给药后不同时间收集血样和置换液,用HPLC检测药物浓度,用3P97软件计算药代动力学参数。结果在静脉滴注美罗培南1.0 g后。血药浓度-时间数据以二室模型拟合最佳,t_(1/2α)为(0.25±0.06)h,t_(1/2β)为(6.96±2.17)h,C_(max)为(48.50±12.32)mg·L^(-1),Vc为(24.48±7.21)L,AUC为(203.20±48.61)mg·h·L(-1)。结论美罗培南在CRRT患者的主要药代动力学参数与健康者有较大的差异,临床应用时应适当减少剂量或延长给药间隔。

Objective To study the pharmacokinetics of meropenem in the patients with continuous renal replacement therapy （CRRT）. Methotis Each of 10 patients with CRRT was given a dose of 1000 mg of meropenem with iv during 30 min. Serum and displacement liquid samples were collected. The concentrations of meropenem in serum and displacement liquid were measured. The software of 3P97 was used to determine the pharmacokinetic parameters. Results Two - compartment model was the best to describe the meropenem concentration - time relation when given intravenolisly. Pharmacokinetic parameters of meropenem in 10 patients with CRRT were follows ： t1/2α was （0.25 ± 0.06 ） h, t1/2β was （6.96±2.17） h, Cmax was （48.50±12.32） mg·L^-1,Vc was（24.48 ±7.21 ）L, AUC was （203.20 ±48.61 ） mg· h · L^-1. Conclusion There was significant difference between the pharmaeokinetic parameters of meropenem from the patients with CRRT and that from the normal volunteers. It is necessary to appropriate reduce dose or extend dosing interval in clinical use.