甲硝唑与替硝唑在人胆汁中的代谢特点及意义

Metabolic Characteristics and Its Effects of Metronidazole and Tinidazole in Human Bile

目的 探讨甲硝唑及替硝唑在人胆汁中的代谢特点 ,为临床用药提供理论依据。方法 通过临床行逆行胰胆管造影+鼻胆管引流直接获取胆汁 ,利用高效液相色谱法 ,连续动态监测给药后血液及胆汁内两种抗生素的浓度变化和代谢特点。结果一次性给药 0 2 5h后两种抗生素在胆汁内即可达到有效杀菌浓度 ,替硝唑在胆汁内药物浓度较平稳 ,但峰浓度不如甲硝唑高 ,在2 4h内两种抗生素胆汁内浓度高于有效杀菌浓度 ,16h后药物浓度有回升现象。结论 甲硝唑及替硝唑为抗胆道厌氧菌感染的最佳抗生素选择 ,对一般感染可每日一次给药 ,对重症感染可选择甲硝唑 。

Objective To investigate the regulation of metabolic characteristics of metronidazole and tinidazole in human bile,and provide a theoretic basis for physician selecting antibiotic rationally when biliary tract was infected.Methods Samples of hman bile were obtained by ERCP plus ENBD,contents of metronidazole and tinidazole were simultaneously measured by HPLC method in the human bile and plasma.Results 0 25 hour after metronidazole and tinidazole were given through iv,contents of two antibiotics had reached the effective bactericida.Concentraction,content of tinidazole in the bile was relatively stable,but its C max was lower as compared with the metronidazole,contents of the two antibiotics in bile were continuously higher than those of the effective bactericidal in 24 hours,and after 16 hours and re-raise was observed in contents of the two antibiotics in bile.Conclusion As maintaining a higher concentration level for long time in the bile by iv,metronidazole and tinidazole were recommended in the patients with an infection in biliary truct.