结核性脑膜炎患者脑脊液中左氧氟沙星浓度监测分析

Cerebrospinal fluid concentration of levofloxacin in patients with tubercular meningitis

目的评价结核性脑膜炎(结脑)患者脑脊液中左氧氟沙星浓度监测的临床意义。方法运用高效液相色谱法测定8例结脑患者脑脊液中左氧氟沙星峰浓度时间(tmax)左右3个时间点(2、4、6 h)的浓度。结果结脑患者脑脊液tmax左右3个时间点的平均左氧氟沙星浓度分别是(0.94±0.39)(2 h)、(2.36±0.42)(4 h)、(2.14±0.32)(6 h)μg·mL-1,所有测定值均高于最小抑菌浓度(MIC,0.5μg·mL-1)。每位结核性脑膜炎患者tmax左右3个时间点的最大浓度均高于最小杀菌浓度(MBC,1.0μg·mL-1)。结论结核性脑膜炎患者口服左氧氟沙星400 mg,1次·d-1,脑脊液中浓度能达到治疗水平。

Objective To evaluate the clinic significance of monitoring the cerebrospinal fluid concentration of levofloxacin in patients with tubercular meningitis（TM）.Methods The data of 8 TM patients whose cerebrospinal fluid concentration of levofloxacin was determined by high performance liquid chromatography（HPLC）,were assessed retrospectively.Results The average cerebrospinal fluid concentration of levofloxacin at 2,4,and 6 h was（0.94 ± 0.39）,（2.36 ± 0.42）,and（2.14 ± 0.32）μg·mL-1,respectively.Every value was above minimal bactericidal concentration（0.5 μg·mL-1）.The maximum concentration in every TM patient was above minimal bactericidal concentration（1.0 μg·mL-1）.Conclusion After the administration of levofloxacin（400 mg,qd） in TM patients,the cerebrospinal fluid concentration of levofloxacin reaches the treatment level.