甲硝唑、替硝唑在乳汁中的含量及其对母乳喂养新生儿的影响

Pharmacokinetics of Metronidazole and Tinidazole in Human Dreast and the Effects on Dreast-fed Infants

目的 测定产后静脉滴注甲硝唑和替硝唑产妇乳汁中的药物含量 ,了解乳汁中的药物浓度及对婴儿造成的影响。 方法 采用高效液相色谱法测定乳汁药物浓度及新生儿经母乳摄入药物含量。 结果 哺乳妇女单剂量静滴甲硝唑 (2 0 m g/ kg,n=8)、替硝唑 (13m g/ kg,n=7)后 ,其乳汁中甲硝唑达峰浓度时间 (tmax)为 (1.7± 1.0 ) h,甲硝唑含量达峰浓度 (cmax)为 (2 0± 5 ) mg/ L;乳汁中替硝唑其 tmax、Cmax分别为 (1.3± 0 .6 ) h和 (17± 3) m g/ L。由 cmax计算得新生儿每日经母乳摄入的甲硝唑及替硝唑含量分别是 3.0 2 mg/ (kg· d)及 2 .5 8mg/ (kg· d) ,仅仅是甲硝唑用于婴儿治疗剂量的1/ 10～ 1/ 5 ,是替硝唑的约 1/ 8～ 1/ 6。 结论 静滴甲硝唑、替硝唑的乳母 ,即使坚持哺乳对婴儿也是相对安全的。但为了使甲硝唑、替硝唑对乳儿造成的不良反应减至最小 ,建议哺乳时避开母乳中药物峰浓度时间 ,慎重起见 。

Objective To investigate the effect of metronidazole and tinidaxole in breast milk on infants and their concentrations. Methods The concentration of metronidazole and tinidazole inbreast milk was assayed by high performance liquid chromatography(HPLC). Results The pharmacokineticparameters(mean±s) t max(h), t 1/2ke of Metronidazole(20 mg/kg, n=8 ) and Tinidazole (13 mg/kg,n=7) in lactation women infused with a single dose were(1.7±1.0)h、(20±5) mg/L and (1.3±0.6)h、(17±3) mg/L respectively. The total amount of metronidazole and tinidazole ingested by the infant via breast milk were 3.02 mg/kg/day and 2.58 mg/(kg·d) respectively. which were 1/5~1/10. and 1/6~1/8 of the routine therapeutic dose for infants.