头孢哌酮/舒巴坦不同给药方式治疗重症肺炎的药代及药效动力学研究

目的探讨重症肺炎患者应用头孢哌酮/舒巴坦的药代及药效动力学影响。方法20例重症肺炎患者随机分为观察组和对照组,每组各10例,均接受头孢哌酮/舒巴坦抗感染治疗,对照组静脉給药输注30 min,观察组采用静脉给药输注3 h。分别于第1次治疗給药前及给药后的不同时间点采集患者动脉血2 ml,选择超高效液相色谱-电噴雾串联质谱分析方法测定头孢哌酮和舒巴坦的浓度,计算药动学数据(C max、AUC_(0-∞)、t12、CL、Vd等),结合不同细菌的MIC值进行计算%T>MIC比值。结果对照组患者头孢哌酮的药动学参数为C_(max)(83.85±15.44)mg/L、AUC_(0-∞)(924.19±141.27)mg·L^(-1)·^(-1)、t1/2(3.30±0.64)h、CL(7.61±0.28)L/h、Vd(36.16±6.93)L/kg,舒巴坦的药动学参数为C_(max)(66.97±1.54)mg/L、AUC_(0-∞)(323.31±161.27)mg·L^(-1)·^(-1)、t1/2(1.74±0.07)h、CL(18.49±1.00)L/h、Vd(46.28±3.03)L/kg。观察组悲者头孢哌酮的药动学参数为C_(max)(68.19±3.95)mg/L、AUC_(0-∞)(811.00±382.08)mg·L^(-1)·^(-1)、t1/2(4.02±1.18)h、CL(6.66±0.35)L/h、Vd(26.28±3.33)L/kg,舒巴坦的药动学参数为C_(max)(22.28±2.74)mg/L,AUC_(0-∞)(324.39±183.04)mg·L^(-1)·^(-1)、t1/2(1.49±0.34)h、CL(17.98±5.06)L/h、vd(36.58±4.77)L/kg。观察组%T>MIC优于对照组。结论头孢哌酮/舒巴坦临床应用于重症肺炎,可采取3 h延长输注时间抗感染。

Objective To discuss pssible altered pharmacokineics and pharmacodynamic induced by cpopenazn/subacam in paients with severe pneumonia.Methods Twenty patients with severe pneumonia were randomly divided into observation group and control group.Each group received 10 cases of cefoperazone/sulbactam anti-infective treatment.The control group received intravenous infusion for 30 minutes,and the observation group rceived intravenous infusion 3 h.Collect 2 ml of patient’s arterial blood at diferent time points before and ater the first treatment,and select the ulta-high performance liquid chromatography-elecrospray tandem mass spectrometry method to determine the concentration of cefopernazone and sulbactam.Kinetic data(C_(max),AUC_(0-∞),t1/2,CL,Vd,etc.),combined with the MIC values of different bacteria to calculate%T>MIC ratio.Results The pharmacokinetic parapneters of cefoperazone in the control group were C_(max)(83.85±15.44)mg/L,AUC_(0-∞)(924.19±141.27)mg·L^(-1)·^(-1),t1/2(3.30±0.64)h,CL(7.61±0.28)L/h,Vd(36.16±6.93)L/kg,the pharmacokinetic parameters of sulbactam are Cuas(66.97+1.54)mg/L,AUC_(0-∞)(323.31±161.27)mg·L^(-1)·^(-1),tu(1.74±0.07)h,CL(18.49±1.00)L/h,Vd(46.28±3.03)L/kg.The pharmacokinetic parameters of cefoperazone in the observation group were C_(max)(68.19±3.95)mg/L,AUC_(0-∞)(811.00±382.08)mg·L^(-1)·^(-1),t1/2(4.02±1.18)h,CL(6.66±0.35)L/h,Vd(26.28±3.33)L/kg,the pharmacokinetic parameters of sulbactam are Cuu(22.28±2.74)mg/L,AUCo-(324.39±183.04)mg·L^(-1)·^(-1),t12(1.49±0.34)h,CL(17.98±5.06)L/h,Vd(36.58±4.77)L/kg.The observation group's%T>MIC is better than the control group.Conclusion Cefoperazon/sulbactam is cinically applied to severe pneumonia can take 3 hours to extend the infusion time to fight infection.