左旋氧氟沙星在胆道手术患者的药代动力学研究

Pharmacokinetics of levofloxacin in patients undergoing biliary tract surgery

目的 研究左旋氧氟沙星 (Levofloxacin ,LVFX)在胆道手术患者的药代动力学。方法 13名施行胆道手术并行T 管引流的患者口服LVFX 2 0 0mg ,q8h ,连服 5d ,用高效液相色谱法测定LVFX在血浆、胆汁、尿中的药物浓度。结果 胆道手术患者术前单次口服LVFX后 ,达峰时间为 (1 95± 1 10 )h ,峰浓度为 (1 5 8± 0 94)mg/L ,消除半衰期为 (3 91± 1 2 8)h ,曲线下面积为 (10 76±5 97)h·mg/L ,其体内药代动力学行为与健康人相比有明显不同 ;无论是单次给药还是多次给药 ,LVFX在胆汁中的浓度均大于血浆浓度 ,胆汁药物浓度均超过胆道常见病原菌的MIC。结论 外科手术影响LVFX的吸收 ,降低体内药物浓度 ;

Objective To study the pharmacokinetics of levofloxacin(LVFX) in patients undergoing biliary tract surgery. Methods Thirteen patients undergoing biliary tract operations with T tube drainage were given LVFX 200 mg every 8 h for 5 d. The concentrations of LVFX in plasma, bile and urine samples were measured through high performance liquid chromatography(HPLC). Results The pharmacokinetic parameters of thirteen patients were obviously different from those in healthy volunteers. T max was (1.95±1.10)h,C max was (1.58±0.94)mg/L,t 1/2 (ke) was (3.91±1.28) h, AUC was (10.76±5.97)h·mg/L. The biliary LVFX concentrations were almost higher than the plasma LVFX concentrations, and biliary LVFX concentrations exceeded the MICs of most common biliary tract pathogens. Conclusion The surgery influences the pharmacokinetics of LVFX. The broad antibacterial spectrum of LVFX and its high biliary concentration suggest that this drug may be useful in treatment and prophylaxis of biliary tract infection.