肺部感染患者血清中万古霉素浓度的监测

Monitoring of vancomycin serum concentration of patients with pulmonary infection

目的建立高效液相色谱法快速测定人血清中万古霉素浓度的方法,用于肺部感染患者药物治疗监测。方法色谱柱为Eclipse XDB C18柱(4.6 mm×250 mm,5μm);流动相为25 mmol·L-1磷酸二氢钾-甲醇(86∶14),流速为1.0mL·min-1,紫外检测波长为236 nm,进样量为20μL,柱温为40℃。结果万古霉素在5～100 mg·L-1内线性关系良好(r=0.999 6),最低定量下限为5.0mg·L-1,日内、日间RSD分别为6.06%和6.27%,回收率为94.87%。所监测的15例肺部感染患者中,有26.67%患者万古霉素浓度<10 mg·L-1。结论该法简便、灵敏、快速、重复性好,可用于肺部感染患者万古霉素的血药浓度监测。万古霉素后血药浓度变化较大,需要药物浓度监测,制定个体化给药方案。

Objective To establish a HPLC method for determination of vancomycin in serum and using the method for clinical monitoring the levels of vancomycin of patients with pulmonary infection.Methods HPLC analysis was performed using a Eclipse XDB C18 column（4.6 mm × 250 mm,5 μm）.The mobile phase was KH2PO4（25 mmoL.L-1） ： methanol（86 ∶ 14）.The flow-rate was 1.0 mL.min-1 and the detection wavelength was 236 nm.The injection volume was 20 μL and the temperature of column was about 40 ℃.Results The concentration range of vancomycin was 5-100 mg.L-1 while the calibration curve showed good linearity（r = 0.999 6）,and the minimum limit o f quantitation was 5.0 mg.L-1.The coefficient of methods recovery were 94.87 %.There lative standard deviations（RSD） of intra-day and inter-day were 6.06 % and 6.27 %,respectively.More over,the concent ration of vancomycin was lower than 10 mg.L-1 in 26.67 % of those 15 patients with pulmonary infection.Conclusion The method is simple,sensitive,rapid and highly reproducible,and it could be used for detecting the concentration of vancomycin in for pulmonary infection patients.The concentration of vancomycin has a large fluctuation in pulmonary infection and their suitable individual dosage regimen need to be administrated through therapeutic drug monitoring.