培氟沙星对老年肺炎患者肾功能影响

Effect of pefloxacin concentraction in blood and sputum in the aged pneumonia patients with impairment of renal function

目的 :研究培氟沙星在老年肺炎同时伴有肾功能不同程度障碍患者中的血、痰药浓度、临床效果及药物毒性。方法 :按肾功能障碍分 4组 ,均以培氟沙量 40 0mg静脉滴注 ,间隔 12h ,疗程 10y。记录临床表现、实验室指标、生物法测定用药后血、痰药物浓度 ,行对比分析。结果 :4组患者血及痰药物浓度依肾功能障碍程度不同而不同。肾功能正常及轻度障碍组 ,血药浓度与痰药浓度接近 ,临床有效率分别是 83 %及 80 % ,细菌清除率 86% ,肾功能中度及重度障碍组血药及痰药浓度随肾功能加重而差距增大 ,临床有效率分别为66%及 5 3 % ,细菌清除率分别是 5 7%及 3 6% ,不良反应增多。该药对中、重度肾功能障碍者有肾毒性。结论 :中度肾功能障碍者用该药时应改善肾功能及延长给药时间 。

Objective: To study the drug cancentration in blood and sputum,clinical effect and drug toxicity of pefloxacin in the aged pneamonia patients with different degree of impairment of renal functian.Methods: The patients were divided into four groups according to ehe impairment of renal funetion,pefloxacin 400 mg/12 h venous inflow,period of treatment is 10 days,clinical manifestation and experimental index were registered,the drug concentration in blood and sputum was measured with biochemical technique,then compared and analyzed.Results: The drug concentration in blood and sputum in four groups differed form the degree of the impairment of renal function,The concentration of drug in blood and sputum of the normal renal function was close to that in the lowgrade impairment of renal function,their clinical effective ratios were 83%,80%,bacterial cleanup ratio was 86%,The difference of drug concentration in blood and sputum in the severe impairment of renal function was greater than that in the moderate renal function group,their clinical effective ratios were 66%,53%,bacterialcleanup ratios were 57%,36%,adverse reaction was growing along with degree of renal function,this drug has renal toxicity for moderate and severe impairment of renal function.Conclusion: in case of moderate impairment of enal function,pralongation of dose interval should be considered,pefloacin should be avoided in severe impairment of renal function.