氨溴索对支气管肺泡灌洗液中头孢克肟浓度的影响

Influence of ambroxol on cefixime levels in bronchoalveolar lavage fluid

目的：对粘痰溶解剂氨溴索（Ａｍｂ）与第三代口服头孢菌素头孢克肟（Ｃｅｆ）合用后Ｃｅｆ肺渗透性进行研究，为临床二者合用提供理论依据。方法：１６例呼吸系患者随机分为两组；Ｃｅｆ组给予Ｃｅｆ０．１ｇ，Ｂｉｄ，连服３ｄ；Ｃｅｆ＋Ａｍｂ组除同Ｃｅｆ组给予Ｃｅｆ外，加服Ａｍｂ６０ｍｇ，Ｔｉｄ，连服３ｄ。于最后一次服药后３ｈ行支气管肺泡灌洗术，收集支气管肺泡灌流液（ＢＡＬ），同时收集病人血浆。用固相萃取技术富集、纯化血浆及ＢＡＬ中Ｃｅｆ之后，采用ＨＰＬＣ测定Ｃｅｆ浓度。结果：Ｃｅｆ组和Ｃｅｆ＋Ａｍｂ组血浆浓度分别为０．９±０．７，０．９±０．４ｍｇ·Ｌ－１，ＢＡＬ中Ｃｅｆ浓度分别为０．０２２±０．０１１，０．０３７±０．０１４ｍｇ·Ｌ－１。

OBJECTIVES:To study the influence of ambroxol on cefixime levels in bronchoalveolar lavage fluid samples from the patients treated with cefixime or with cefixime and the mucolytic agent ambroxol. METHODS:The controlled study was conducted on 16 patients. They were allocated to two groups in randomized order. One group cefixime 100 mg bid ( n =8) and the other with cefixime 100 mg bid+ambroxol 60 mg tid( n =8). The drugs were given during the 3 days preceding the diagnostic examination; the last dose was given approximately 3h before bronchoscopy. The bronchoalveolar lavage fluid were collected in sterile tubes and the plasma sample was obtained simuiltaneously. Cefixime in plasma and BAL were enriched extracted and purified using Sep pak C 18 solid phase extraction columns, followed by assay using HPLC. RESULTS:The cefixime in plasma were 0.9 ± 0.7 mg·L -1 in the group receiving ambroxol and 0.9 ± 0.4 mg·L -1 in the controlled group. There were no significant differences in the plasma levels. And the cefixime in BAL were 0.037 ± 0.014 mg·L -1 in the group with ambroxol and 0.022 ± 0.011 mg·L -1 in other. The difference of cefixime in the BAL was statistically significant ( P < 0.05 ). Comparisons of protein concentrations in BAL samples did not show significant differences in two groups. CONCLUSION:These results showed that ambroxol was able to increase cefixime concentration in the lung after co administration cefixime with ambroxol.