Individual Differences in Blood Alcohol Concentrations after Moderate Drinking Are Mainly Regulated by Gastric Emptying Rate Together with Ethanol Distribution Volume

Blood alcohol concentration (BAC) differs greatly among individuals, even when people of the same sex and age drink alcohol under the same drinking conditions. In this study, we investigated the main factors involved in the internal reg-ulation of individual differences in BAC, focusing on the alcohol dehydrogenase 1B (ADH1B) genotype, blood acetal-dehyde concentration (BAcH), amount of habitual alcohol consumption, pharmacokinetic parameters of BAC, distribution volume of ethanol (Vd), and gastric emptying rate (GER) under the same drinking conditions. Twenty healthy Japanese males aged between 40 and 59 years old and having the aldehyde dehydrogenase 2 (ALDH2) genotype of ALDH 2*1/*2 were recruited for this study. The subjects were given 0.32 g ethanol/kg body weight in the form of commercially available beer (5%, v/v). The results showed that BAC-max differed greatly among individuals with a more than two-fold variation. When the BAC-time curve was compared among ADH1B genotypes (ADH1B*1/*1, *1/*2, and *2/*2), there were no differences in BAC among the genotypes. Although BAcH, monthly alcohol consumption, elimination rate of blood ethanol (β value) and ethanol disappearance rate from the body (EDR) can affect BAC, all of them had no correlations with BAC-max. However, Vd (liter/kg), ΔPlasma glucose concentration (ΔPGC = PGC30 min ? PGC0 min) and the serum concentration of gastric inhibitory polypeptide (GIP) did correlate with BAC-max. Model 2 in multiple linear regression analysis showed the optimal model for Vd and GIP with positive correlations with BAC-max. As GIP and ΔPGC are both reflected by gastric emptying rate (GER), we concluded that the individual differences in BAC after moderate drinking are mainly regulated by GER together with Vd. These findings demonstrate that together with body water content, the gastrointestinal tract plays an important role in the regulation of individual differences in BAC, involving first pass metabolism of ethanol.

Predictive value of blood concentration of biologics on endoscopic inactivity in inflammatory bowel disease:A systematic review

BACKGROUND Although blood concentration of biologics is an important composition of disease management in inflammatory bowel disease(IBD)patients,complexity and uncertainty of biological management encourage many disputes in predicting the outcome of IBD patients through blood concentration of biologics.AIM To verify the predictive value of blood concentration of biologics on endoscopic inactivity in IBD patients under different situations.METHODS We searched PubMed/MEDLINE,Embase,and Web of Science up to May 2020 and identified IBD patients as the research cohort as well as the correlations between blood concentration of biologics and endoscopic inactivity in IBD patients as the research direction.RESULTS A total of 23 articles with 30 clinical studies and 1939 IBD patients were included.The predictive cut-off value of blood concentration of infliximab on mucosal healing should be 2.7-10.6μg/mL in IBD.Blood concentration of infliximab reaching 5.0-12.7μg/mL or more increased the probability of fistula healing/closure in perianal fistulizing Crohn's disease.Blood concentration of adalimumab reaching 7.2-16.2μg/mL or more could predict mucosal healing in IBD.The predictive cut-off value of blood concentration of adalimumab on fistula healing/closure should be 5.9-9.8μg/mL in perianal fistulizing Crohn's disease.Blood concentration of vedolizumab surpassing 25.0μg/mL indicated mucosal healing in ulcerative colitis patients under maintenance therapy and the predictive cut-off value of blood concentration on mucosal healing or endoscopic remission under induction therapy in IBD could be 8.0-28.9μg/mL.CONCLUSION Blood concentration of biologics should not be utilized to predict endoscopic inactivity of IBD independently due to discrepancies in clinical studies,whereas conducting therapeutic drug monitoring intensively contributes to precise therapy.

Changes in blood alcohol concentration and driving ability after alcohol intake

Objective: To study the relationship between the amount of consumed alcohol, blood alcohol concentration (BAC), and driving ability among a part of the population in Southwest China and to provide reference for the formulation of the legal limits for safe driving. Methods: Seventy-six randomly selected volunteer drivers each had three times of alcohol intake (100 ml each time). After each drank, BAC was measured with gas chromatograph and driving ability was evaluated. The drivers were grouped according to age, weight, alcohol tolerance and driving experience respectively and changes in BAC and driving ability were analyzed. Results: Average BAC and the percentage of drivers showing impaired driving ability in the groups increased after each intake of 100 ml alcohol. BAC in Group≤60 kg was more susceptible to alcohol than that in Group>60 kg. When each drank, alcohol had greater influence on drivers who had comparatively shorter driving experience. Conclusion: Volume of consumed alcohol, BAC and driving ability have direct associations among one another and are all under the influence of various factors including individual conditions. To set an appropriate legal BAC limit for safe driving should take an overall consideration of all factors.

Amperometric Enzyme Biosensor for the Determination of High Concentration Lactate in Whole Blood of Athletes

<正>Amperometric biosensor applied to the determination of high concentration lactate in serum and whole blood was described.The biosensor was constructed by gold electrode modified with nanoplatinum particles.Lactate oxidase (E.C.1.1.3.2) was immobilized at platinized activated gold electrode which was used for the determination of high concentration lactate at low potential (+0.2 V).The linear calibration graphs were obtained from 1 to 21 mmol·L~ (-1) lactate in serum and from 0.9 to 13.2 mmol.L~ (-1) lactate in whole blood.The correlation coefficients were 0.99 and 0.97,respectively at a steady-state response time of 50 s.

Study of blood fat concentration based on serum ultraviolet absorption spectra and neural network

Blood plays an important role in the clinical di-agnosis and treatment, the analysis of blood will be of very important practical significance. The experiment shows that the absorption spectra of blood are of serious noise in the wave band of 200 to 300 nm, which hides the useful spectral characteristics. The effective separation of the noise was achieved by db4 wavelet transform, and the signals of reconstruction have been obviously improved in the noise serious wave band, reflecting some useful information. The absorption peaks of different samples are displaced to some degrees. The correlation between absorbance at 278nm and blood fat concentration is no significant and random. Based on the evident correlation between serum absorption spectrum and blood fat con-centration in the wave band of 265 to 282nm, a neural network model was built to forecast the blood fat concentration, bringing a relatively good prediction. This provides a new spectral test method of blood fat concentration.

Natural Compound Formula RM88 Significantly Reduces Blood Alcohol Concentration in Humans

There is extensive worldwide use for the social consumption of alcohol. Abuse of alcohol causes substantial personal, psychological and medical health issues. In addition, there are significant national economic costs from lost productivity. However, there are limited pharmaceutical drugs for the treatment of alcohol overuse. Historically, many cultures have used herbs and other natural compounds to reduce problematic alcohol induced behaviour but the evidence is anecdotal. This study investigated if a natural compound formula (RM88) that was developed could reduce blood alcohol concentration (BAC) in a controlled case series. Thirteen subjects (5 males, 8 females, age range 18 to 85 years) completed 16 paired sessions of alcohol only versus RM88 with alcohol. Subjects consumed one to three standard drinks of beer, wine or spirits (14.7 to 29.4 gm alcohol). Measurements were made by a fuel cell breathalyzer for a period of 90 minutes. Summated BAC showed a reduction in 94% (15/16) of paired test sessions (BAC reduction range 23% - 79%, mean 50.9% ± 16.5%, p = 0.0005). Data normalized to 20 gm alcohol (two standard drinks) showed a significance of p = 0.00026. One subject on prednisone and hydroxychloroquine drugs had increased BAC from RM88. The average reductions of BAC for the beverages were spirits 34% (n = 3), beer 36% (n = 3), and wine 52% (n = 10). RM88 showed that this combination of natural compounds was very effective in reducing maximal peak concentrations of alcohol.

Study of blood sugar concentration based on serum UV absorption spectra＊

UV absorption spectrum and neural network theory was used for the analysis of blood sugar concentration. Experimental investigation shows that absorption spectrum has the following characteristics in the wave band of 200-300 nm： （1） The absorption spectrum is of complex shape, there is more absorption peak in UV-band, it shows that there is a complex absorption phenomenon in blood group macromolecules; （2） The curve shapes of absorption spectra are similar to different samples ,the reason is that the spectrum is synthesis of some group macromolecules absorption spectrum; （3） There is a degree of displacement of absorption peak to different samples; （4） There is no significant correlation between absorbance and blood sugar concentration at 278 nm, but random. Based on the wave band of 280 nm to 300 nm, a neural network model was built to determine the blood sugar concentration.

The clinical value of enzyme-multiplied immunoassay technique monitoring the plasma concentrations of cyclosporine A after renal transplantation

The feasibility and the clinical value of the enzyme-multiplied immunoassay technique （EMIT） monitoring of blood concentrations of cyclosporine A （CsA） in patients treated with CsA were investigated after kidney transplantation. The validation method was performed to the EMIT determination of CsA blood concentration, the CsA whole blood trough concentrations （Co） of patients in different time periods after renal transplantation were monitored, and combined with the clinical complications, the statistical results were analyzed and compared. EMIT was precise, accurate and stable, also with a high quality control. The mean postoperative blood concentration of CsA was as follows： 〈1 month, （281.4± 57.9）ng/mL; 2 - 3 months, （264.5 ± 41.2） ng/mL; 4 - 5 months, （236.4 ± 38.9） ng/mL; 6 - 12 months, （206.5± 32.6）ng/mL; 〉12 months, （185.6± 28.1）ng/mL. The toxic reaction rate of CsA blood concentration within the recommended therapeutic concentration was 14.1%, significantly lower than that of the none-recommended dose group （37.2%） （P〈0.05）; the transplantation rejection rate was 4.4%, significantly lower than that of the none- recommended dose group （22.5%） （P〈0.05）. Using EMIT to monitor the blood concentration of CsA as the routine laboratory method is feasible, and is able to reduce the CsA toxicity and rejection significantly, leading to achieving the desired therapeutic effect.

Effects of oxygen concentration and flow rate on cognitive ability and physiological responses in the elderly

The supply of highly concentrated oxygen positively affects cognitive processing in normal young adults. However, there have been few reports on changes in cognitive ability in elderly subjects following highly concentrated oxygen administration. This study investigated changes in cognitive ability, blood oxygen saturation （%）, and heart rate （beats/min） in normal elderly subjects at three different levels of oxygen [21% （1 L/min）, 93% （1 L/min）, and 93% （5 L/min）] administered during a 1-back task. Eight elderly male （75.3 ＋ 4.3 years old） and 10 female （71.1 ＋ 3.9 years old） subjects, who were normal in cognitive ability as shown by a score of more than 24 points in the Mini-Mental State Examination-Korea, participated in the experiment. The experiment consisted of an adaptation phase after the start of oxygen administration （3 minutes）, a control phase to obtain stable baseline measurements of heart rate and blood oxygen saturation before the task （2 minutes） and a task phase during which the 1-back task was performed （2 minutes）. Three levels of oxygen were administered throughout the three phases （7 minutes）. Blood oxygen saturation and heart rate were measured during each phase. Our results show that blood oxygen saturation increased, heart rate decreased, and response time in the 1-back task decreased as the concentration and amount of administered oxygen increased. This shows that administration of sufficient oxygen for optimal cognitive functioning increases blood oxygen saturation and decreases heart rate.

阿帕替尼血药浓度测定方法的建立及临床应用

目的 建立测定阿帕替尼血药浓度的方法并进行临床应用。方法 采用超高效液相色谱(UPLC)法进行血药浓度测定,色谱柱为ACQUITY UPLC BEH C18,流动相为乙腈-0.1%甲酸水溶液(梯度洗脱),流速为0.2 mL/min,柱温为40℃,进样量为5μL。收集26例服用阿帕替尼癌症患者的病例资料,检测其血药浓度,分析阿帕替尼血药浓度与患者年龄、给药剂量、不良反应及联合用药的相关性,并检测患者治疗前后血清肾损伤相关因子[胱抑素C(CysC)、肾损伤分子1(KIM-1)、白细胞介素18(IL-18)、肿瘤坏死因子α(TNF-α)]水平。结果 阿帕替尼检测质量浓度在500~2 000 ng/mL范围内线性关系良好,精密度试验RSD为3.7%,稳定性试验RSD为4.9%,平均加样回收率为96.0%(RSD为2.1%)。26例患者的阿帕替尼血药浓度最低为103 ng/mL,最高为1 932ng/mL。患者的血药浓度随年龄呈波动降低趋势。在0.125或0.25 g给药剂量下,服用阿帕替尼的患者体内血药浓度集中在1 000~2 000 ng/mL范围内。26例癌症患者中有13例发生不良反应,其中血药浓度500~<1 000 ng/mL者未见不良反应发生。20例患者同时联用了其他药物,其血药浓度高低不同。治疗后,患者的血清CysC、KIM-1、IL-18、TNF-α水平均显著高于治疗前(P<0.05)。结论 所建立的UPLC方法能快速检测阿帕替尼血药浓度。临床使用阿帕替尼时应综合考虑患者年龄和药物联用等情况,并注意防范阿帕替尼可能导致的急性肾损伤。

Accuracy evaluation of Roche Accu-Chek Performa blood glucose meters at low glucose concentrations:A nine-year retrospective study

Objective:To evaluate the accuracy of Roche Accu-Chek Performa glucose meters at a low glucose concentration of<5.55 mmol/L(100 mg/dL)over a 9-year period.Methods:The accuracy of the Roche Accu-Chek Performa glucose meters at low glucose concentrations was evaluated using annual comparison data for 9 consecutive years from 2015 to 2023,according to the acceptability criteria specified in International Organization for Standardization(ISO)15197:2013.Blood samples with low glucose concentrations of<5.55 mmol/L were prepared by incubation and glycolysis.The glucose concentration was detected using Roche Accu-Chek Performa glucose meters and a biochemical analyzer in the central laboratory.Results:A total of 2978 pairs of comparison results from 211 glucose meters at a low glucose concentration of<5.55 mmol/L were retrospectively analyzed from 2015 to 2023.The clinical use duration spanned from 1 to 9 years and 40.76%(86 out of 211 glucose meters)had been used for more than 2 years.The correlation coefficient r between glucose meter measurements and laboratory reference values was 0.98(p<0.001).The mean according to Roche Accu-Chek Performa glucose meters was 0.05 mmol/L(0.9 mg/dL)higher than that of the biochemical analyzer(Z=-13.82,p<0.0001).The results showed that 100.00%(211 out of 211)of the Roche Accu-Chek Performa glucose meters met the acceptability criteria specified in ISO 15197:2013.At a low glucose concentration of<5.55 mmol/L,99.90%(2975 out of 2978)of the comparative data pairs in the error distribution fell within the range of±0.83 mmol/L(15 mg/dL).Parkes consensus error grid analysis showed that 100.00%(2978 out of 2978)of comparative data pairs fell within region A.Conclusions:This study demonstrated that Roche Accu-Chek Performa glucose meters successfully met the accuracy standards of ISO 15197:2013 for measuring blood glucose within the hypoglycemic range.Greater attention should be given to the performance of blood glucose monitoring systems in the low glycemic range,especially for patients with diabetes who are prone to hypoglycemia and require precise measurements.

重症感染患者亚胺培南检测方法的建立及临床应用

目的建立适用于检测重症感染患者亚胺培南血药浓度的二维液相色谱法,并应用于临床。方法基于全自动二维液相色谱仪建立亚胺培南血药浓度检测方法,以一维色谱柱Aston SNCB(50 mm×4.6 mm,5μm)萃取分离目标物,再经二维色谱柱Aston SCB(250 mm×4.6 mm,5μm)进一步分离测定。一维流动相为亚胺培南-1D移动相[乙腈-甲醇-水(15∶10∶75,V/V/V)],流速为1.0 mL/min;二维流动相为72%OPI-1有机移动相(色谱级甲醇)-20%BPI-1碱性移动相[水(含20.0 mmol/L的磷酸铵,用三乙胺调pH至7.2)]-8%API-1酸性移动相[水(含20.0 mmol/L的磷酸铵,用磷酸调pH至3.0)],流速为1.0 mL/min;柱温为40℃,紫外检测波长为310 nm,进样量为100μL。洗脱程序:0~3.40 min,一维色谱柱(亚胺培南-1D移动相);3.40~11.00 min,二维色谱柱(72%OPI-1有机移动相-20%BPI-1碱性移动相-8%API-1酸性移动相)。结果亚胺培南检测质量浓度的线性范围为0.171~18.570μg/mL(R^(2)=0.9999),定量下限为0.171μg/mL;回收率在93.47%~106.16%(n=5),日内和日间精密度的RSD均低于15%(n=5)。51例患者的亚胺培南谷浓度为0~19.57μg/mL。结论所建立的方法前处理简单、快捷,进样量大,可用于重症感染患者亚胺培南血药浓度的检测。

1例类鼻疽脓毒症患者的全程个体化药学监护

目的为类鼻疽脓毒症(MS)抗菌药物治疗方案的调整、不良反应的识别和个体化药学监护提供参考。方法临床药师利用血药浓度和基因检测全程参与1例MS患者强化期和根除期治疗过程。通过测定β-内酰胺类和复方磺胺甲噁唑(TMP/SMZ)血药浓度并计算其药代动力学与药效学(PK/PD)参数,结合文献对MS抗菌药物治疗方案进行调整;同时通过高通量测序检测药物相关基因多态性,对药物不良反应的发生原因进行分析并进行处理。结果临床药师利用血药浓度和基因检测手段,提出了亚胺培南西司他丁钠(IMP)给药剂量调整建议,分析了多种药物不良反应的发生原因;通过测定β-内酰胺类药物和TMP/SMZ血药浓度计算PK/PD靶标,通过查询指南和文献为临床医生解释类鼻疽患者脓毒症期和非脓毒症期状态下的达标情况;利用血药浓度和基因检测分析MS患者神经毒性与IMP cmin的相关性,并发现肾毒性与TMP/SMZ的cmax无关,而与患者饮水量相关。经全程抗菌药物治疗后,患者病情好转出院,不良反应得到有效处理。结论临床药师基于抗菌药物血药浓度和基因检测结果解读情况协助临床医生制定MS治疗方案,并为患者提供全程用药监护,提高了临床药物治疗的安全性和有效性。

ICU患者多黏菌素B血药浓度及不良反应分析

目的 探讨重症监护室(ICU)患者多黏菌素B血药浓度达标情况及不良反应,为临床合理用药提供参考。方法 回顾性分析61例ICU患者使用多黏菌素B治疗后的稳态24 h浓度-时间曲线下面积(AUC_(ss,24h))达标情况、影响因素及不良反应。结果 61例患者多黏菌素B AUC_(ss,24h)达标率为37.70%(23/61)。肌酐清除率与谷浓度(C_(min))及AUC_(ss,24h)差异有统计学意义(P<0.05),肌酐清除率与C_(min)(r=-0.45)及AUC_(ss,24h)均为负相关(r=-0.34)。单因素和多因素分析显示,AUC_(ss,24h)与滴注时间显著相关(P<0.05),输注时间>1小时组AUC_(ss,24h)达标率高于1小时组。虽然AUC_(ss,24h)与年龄及肾功能差异无统计学意义(P>0.05),但是年龄增大或中重度肾功能不全,AUC_(ss,24h)达标率降低。多黏菌素B相关肾损伤发生率为45.24%(19/42),肾损伤组AUC_(ss,24h)>100 (mg·h)/L比例较高。结论 多黏菌素B AUC_(ss,24h)可能与年龄、输注时间及肾功能有关,多黏菌素B相关肾损伤与AUC_(ss,24h)>100(mg·h)/L有关,临床需根据患者情况进行血药浓度监测和个体化给药。

胃肠间质瘤患者服用甲磺酸伊马替尼仿制药和原研药的血药浓度及安全性评估

目的:比较胃肠间质瘤患者服用甲磺酸伊马替尼仿制药与原研药的血药浓度和不良反应,为临床医生和患者选择药物提供参考。方法:收集河北医科大学第四医院2020年12月至2023年12月,在门诊使用甲磺酸伊马替尼药物的胃肠间质瘤患者,分为原研药甲磺酸伊马替尼片组,仿制药甲磺酸伊马替尼片组,以及仿制药甲磺酸伊马替尼胶囊组。通过高效液相色谱质谱联用仪检测患者用药后的伊马替尼及其代谢产物N-去甲基伊马替尼的血液稳态谷浓度。收集患者用药后的所有不良反应,并根据常见不良反应评估标准5.0版(CTCAE 5.0)确定不良反应等级。分析3组患者血药浓度和服药后不良反应的差异。结果:原研药组和两个仿制药组伊马替尼稳态谷浓度,N-去甲基伊马替尼稳态谷浓度,以及伊马替尼和N-去甲基伊马替尼稳态谷浓度之和,差异均无统计学意义(P均>0.05)。原研药和两个仿制药组不良反应等级也无显著差异(P均>0.05)。结论:甲磺酸伊马替尼原研药和两个仿制药安全性无显著差异。

4℃保存全血制备的去白细胞混合浓缩血小板体外质量评价

目的 探讨全血4℃冷藏条件下保存制备去白细胞混合浓缩血小板的可行性,为成分制备提供理论依据。方法 将采集的400 mL ACD-B抗凝全血随机分两组,分别进行4℃和室温保存,在保存后6 h内分离制备出白膜层,于22℃静置过夜保存,次日将白膜层汇集制备去白细胞混合浓缩血小板,于制备后d1、d3、d5、d7取样,进行血细胞计数及相关参数检测,测定pH、葡萄糖、乳酸含量反映代谢情况,检测血栓弹力图、血小板聚集率及PAC-1、CD62P反映血小板体外功能及活化情况,比较两组血小板差异。结果 随着保存时间的延长,两组去白细胞混合浓缩血小板计数逐渐下降,血小板分布宽度(PDW)、平均血小板体积(MPV)、大型血小板比例(P-LCR)均逐渐上升,差异无统计学意义(P>0.05)。两组去白细胞混合浓缩血小板pH、葡萄糖含量均逐渐降低,乳酸含量逐渐增高,无显著性差异(P>0.05)。血栓弹力图结果显示,反应血小板功能的MA值保存期内无显著性变化,且两组间无显著性差异(P>0.05)。血小板聚集率随着保存时间的延长而逐渐降低,两组无统计学差异。血小板PAC-1及CD62P表达率随着保存时间的延长而逐渐升高,两组无统计学差异(P>0.05)。结论 全血4℃冷藏保存与室温保存6 h内制备的去白细胞混合浓缩血小板在体外计数、功能、活化方面无统计学差异,4℃冷藏6 h内的全血可考虑作为制备去白细胞混合浓缩血小板的起始血液。

《治疗药物监测》实验课线上教学模式的探索

随着“互联网+”时代的到来以及移动终端的普及,传统的实验课线下教学模式呈现出一定的短板,线上教学模式成为课程教学体系的重要组成部分。文章以新疆医科大学第一附属医院临床药学专业必修课程《治疗药物监测》实验课“高效液相色谱技术测定卡马西平血药浓度”为例,围绕临床药学专业人才培养目标和课程体系标准,基于线上平台,从课前准备、课中实施、课后巩固三阶段探索实验课线上教学模式,推动了信息技术与课堂的融合发展,激发学生学习积极主动性,促进了传统教学模式的改革,为高校线上线下混合式实验教学提供一定的经验借鉴和参考。

万古霉素腹腔给药治疗腹膜透析相关性腹膜炎的血药浓度监测结果分析

目的:分析腹膜透析相关性腹膜炎(PDRP)万古霉素腹腔给药方案与血药浓度监测情况,探讨万古霉素血药浓度与临床结局的关系。方法:收集2020年1月至2023年4月海南省人民医院经万古霉素腹腔给药治疗且监测血药浓度的40例PDRP患者资料,分析万古霉素血药浓度的分布情况、各方案首次血药浓度水平、依据血药浓度调整给药方案的情况以及血药浓度与临床结局的关系。结果:(1)69例次万古霉素血药浓度结果中,血药浓度主要分布于10~15 mg/L(28例次,占40.58%),平均浓度为(15.54±5.25)mg/L;治疗期间,监测1次、2次和3次及以上血药浓度的患者分别为20、15和5例,其中,依次有6、15和5例患者依据血药浓度调整了万古霉素给药方案。(2)以万古霉素0.5 g,1日1次、隔日1次和隔2日1次腹腔给药;1日1次方案的首次血药浓度为(17.11±4.43)mg/L,隔日1次方案的首次血药浓度为(14.92±4.21)mg/L,隔2日1次方案的首次血药浓度为(11.27±2.66)mg/L,1日1次方案与隔2日1次方案首次血药浓度的差异有统计学意义(P<0.01)。(3)以15 mg/L为界分组,高浓度组与低浓度组患者有效率的差异无统计学意义(P>0.05);以10 mg/L为界分组,浓度<10 mg/L组患者的有效率为25.00%(1/4),显著低于浓度≥10 mg/L组的83.33%(30/36),差异有统计学意义(P<0.05)。结论:万古霉素腹腔给药的血药浓度存在着较大个体差异,建议优先选用0.5 g、1日1次方案或首剂给予更高的负荷剂量,血药浓度维持≥10 mg/L;对于多次给药及方案调整的患者,应动态监测血药浓度。

UGT1A6基因多态性对癫痫患者丙戊酸钠血药浓度的Meta分析

目的:探讨UGT1A6 A541G、A552C基因多态对丙戊酸钠血药浓度的影响。方法:计算机检索PubMed、Medline、Cochrane Library、EMbase、CNKI、万方数据库,检索年限从建库至2024年4月,收集UGT1A6基因多态性与丙戊酸钠血药浓度文献,提取数据与质量评价,采用Revman5.3软件进行Meta分析。结果:共纳入文献11篇,999例癫痫患者。Meta分析结果显示,在UGT1A6 A541G基因中,除AG vs GG[MD=0.16,95%CI(-0.39,0.70),P=0.50]外,AA vs AG[MD=0.53,95%CI(0.32,0.75),P<0.00001],AA vs GG[MD=0.67,95%CI(0.10,1.23),P=0.02],AA vs AG+GG[MD=0.61,95%CI(0.45,0.76)P<0.00001],两者差异均具有统计学意义,说明癫痫患者UGT1A6 A541G AA型丙戊酸钠血药浓度高于AG型或/和GG型。在UGT1A6 A552C中,除AC vs CC[MD=0.21,95%CI(-0.31,0.74),P=0.43]外,AA vs AC[MD=0.90,95%CI(0.77,1.03),P<0.00001],AA vs CC[MD=0.90,95%CI(0.77,1.03),P<0.00001],AA vs AC+CC[MD=1.58,95%CI(1.07,2.10),P<0.00001],两者差异均具有统计学意义,说明UGT1A6 A552C AA型丙戊酸钠血药浓度高于AC型或/和CC型。结论:癫痫患者UGT1A6 A541G和A552C基因多态性与丙戊酸钠血药浓度具有相关性,且基因突变可能导致丙戊酸钠血药浓度降低。

伏立康唑致氯气中毒患者肝损伤1例

目的分析伏立康唑引起药物性肝损伤的原因、机制及影响因素,为临床药物性肝损伤的诊断与治疗提供参考。方法临床药师充分应用药学专业知识,参与1例氯气中毒后继发真菌感染患者的治疗过程。结果临床药师结合用药史及药物作用特点,协助医师查找和判断急性肝损伤的原因、发病机制及治疗方案,最终患者预后良好。结论临床药师参与诊疗,对患者进行用药监护,可降低不良反应的危害,提高临床用药的安全性。