高剂量阿米卡星在PICU败血症患儿体内药代动力学的初步研究

Preliminary study of pharmacokinetics of high dose of amikacin in PICU sepsis children

目的初步探讨5 mg/kg阿米卡星在PICU患儿体内的药代动力学和血液动力学的关系。方法纳入符合条件的30例革兰阴性败血症患儿进行阿米卡星药物治疗研究,通过非房室模型计算每例患儿的阿米卡星的药代动力学。结果阿米卡星在革兰阴性败血症患儿体内平均药物分布为(0.36±0.07)L/kg,平均血液清除率为(3.88±0.97)m L/(min·kg)。肌酐清除率(CCR)与血清肌酸酐(SCr)相关性差异有统计学意义。结论对PICU患儿应用高剂量阿米卡星(≥25 mg/kg)需要考虑败血症对血液动力学的影响,要密切监测败血症患儿血药浓度变化。

Objective To examine the relationship between pharmacokinetics and hemodynamic of 5 mg /kg amikacin in PICU sepsis children. Methods 30 patients who were treated with amikacin following Gram negative sepsis were enrolled. The pharmacokinetic profile of amikacin by a non-compartmental model was calculated for each patient. Results Mean volume of distribution was（ 0. 36 ± 0. 07） L / kg and mean serum amikacin clearance rate was（ 3. 88 ± 0. 97） m L /（ min·kg）. There was significant difference between the relationship of CCR and SCr. Conclusion Using high dose of amikacin（ ≥25 mg / kg） needs to consider hemodynamic response to sepsis and monitor the changes of blood drug concentration.