肝移植术后早期并发腹膜炎患者采用万古霉素的药代动力学及毒性分析
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- 论文作者：王璐 ; 刘晋宁 ; 王鑫 ; 臧运金
- 年：2016
- 作者机构：首都医科大学附属北京佑安医院肝移植中心;
- 论文关键词：肝移植术 ; 腹膜炎 ; 万古霉素 ; 药代动力学
- 英文论文关键词：liver transplantation(olt) ; Peritonitis ; Vancomycin ; pharmacokinetic
- 会议召开时间：2016年6月
- 会议录名称：2016《中国组织化学与细胞化学》杂志临床研究研讨会论文汇编
- 语种：中文
- 分类号：R657.3
- 学会代码：ZHXB
- 会议名称：2016《中国组织化学与细胞化学》杂志临床研究研讨会
- 会议地点：中国北京
- 主办单位：《中国组织化学与细胞化学杂志》社有限公司
- 学会名称：《中国组织化学与细胞化学杂志》社有限公司
- 页数：2
- 文件大小：2632k
- 原文格式：O
- 会议级别：全国
摘要
目的:探讨肝移植术后早期并发腹膜炎患者采用万古霉素的药代动力学及毒性情况。方法:给予在我院接受肝移植术并于术后早期并发腹膜炎的1例患者万古霉素和百令胶囊药物治疗,采用荧光偏振免疫法测量药物治疗前后患者血液、腹水和胆汁中的万古霉素浓度,以P1KBP-N1药代动力学程序计算药代动力学参数,并观察患者体温、白细胞计数、腹痛症状、血液、腹水及胆汁细菌培养结果等药效和毒性情况。结果:万古霉素在患者血液中的药代动力学与开放性三房式模型相一致,腹水中的药代动力学与一房式模型相一致,胆汁中浓度数据无法拟合;药效显著,且无肝肾毒性表现。结论:肝移植术后早期并发腹膜炎患者采用万古霉素的药代动力学特征与健康者是基本一致的,肝移植胆道感染不宜采用万古霉素药物治疗,要采用万古霉素药物治疗中要动态监测血药浓度,制定实施个体化的给药方案。
Objective:to investigate the early after liver transplantation with peritonitis patients using vancomycin pharmacokinetics and toxicity.Method:to accept the liver transplantation in our hospital and in patients with early postoperative peritonitis in 1 case of vancomycin and best capsule drug treatment,measured by fluorescence polarization immunoassay before and after drug therapy in patients with blood,ascites and vancomycin concentration in the bile,PKBP-N1 pharmacokinetic program calculating pharmacokinetic parameters,and observe the patients body temperature and white blood cell count,abdominal pain symptoms,blood,ascites and bile bacteria culture results efficacy and toxicity.Results:the pharmacokinetics of vancomycin in the patients blood type model is consistent with open three room,pharmacokinetic of ascites type model is consistent with a room,bile concentration data cannot fit:Efficacy significantly,and without liver and kidney toxicity.Conclusion:early after liver transplantation with peritonitis patients pharmacokinetic characteristics of vancomycin and health is the basic consistent,liver transplantation with biliary tract infection should not be vancomycin drug treatment,to adopt vancomycin in drug treatment to the dynamic monitoring of blood drug concentration,formulate the implementation of individualized dosage regimen.
Objective:to investigate the early after liver transplantation with peritonitis patients using vancomycin pharmacokinetics and toxicity.Method:to accept the liver transplantation in our hospital and in patients with early postoperative peritonitis in 1 case of vancomycin and best capsule drug treatment,measured by fluorescence polarization immunoassay before and after drug therapy in patients with blood,ascites and vancomycin concentration in the bile,PKBP-N1 pharmacokinetic program calculating pharmacokinetic parameters,and observe the patients body temperature and white blood cell count,abdominal pain symptoms,blood,ascites and bile bacteria culture results efficacy and toxicity.Results:the pharmacokinetics of vancomycin in the patients blood type model is consistent with open three room,pharmacokinetic of ascites type model is consistent with a room,bile concentration data cannot fit:Efficacy significantly,and without liver and kidney toxicity.Conclusion:early after liver transplantation with peritonitis patients pharmacokinetic characteristics of vancomycin and health is the basic consistent,liver transplantation with biliary tract infection should not be vancomycin drug treatment,to adopt vancomycin in drug treatment to the dynamic monitoring of blood drug concentration,formulate the implementation of individualized dosage regimen.
引文
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[4]张弋,吴瑛,沈中阳.万古霉素在我院肝移植患者中的治疗药物监测及临床应用分析[J].中国药房,2011(26):2451-2453.
[5]王芳,王琴,申红.万古霉素与替考拉宁治疗肝移植术后MRSA菌血症疗效与安全性比较[J].药学与临床研究,2013,21(1):81-83.
[6]江涛,王轩,陆雷等.肝移植术后不同时期胆道感染的病原菌分布及耐药性的研究[J].中华医院感染学杂志,2011,21(2):403-406.
[7]申川,周光文,陈瑞等.肝移植术后革兰阳性菌的感染因素及病原菌分析[J].中华医院感染学杂志,2010,20(20):3236-3238.
[8]胡建国,王兵,王新保等.肝癌患者肝移植术后医院感染病原菌分布及耐药性分析[J].中华医院感染学杂志,2014,24(3):588-590
[2]唐勤,葛卫红,丁义涛.万古霉素对肝移植并发腹腔感染的治疗监测及药动学研究[J].江苏药学与I临床研究,2002,10(2):4-6.
[3]蔡常洁,李敏如,易述红,等.生长抑素联合口服万古霉素治疗肝移植术后早期肠梗阻[J].中华胃肠外科杂志,2008,11(4):335-338.
[4]张弋,吴瑛,沈中阳.万古霉素在我院肝移植患者中的治疗药物监测及临床应用分析[J].中国药房,2011(26):2451-2453.
[5]王芳,王琴,申红.万古霉素与替考拉宁治疗肝移植术后MRSA菌血症疗效与安全性比较[J].药学与临床研究,2013,21(1):81-83.
[6]江涛,王轩,陆雷等.肝移植术后不同时期胆道感染的病原菌分布及耐药性的研究[J].中华医院感染学杂志,2011,21(2):403-406.
[7]申川,周光文,陈瑞等.肝移植术后革兰阳性菌的感染因素及病原菌分析[J].中华医院感染学杂志,2010,20(20):3236-3238.
[8]胡建国,王兵,王新保等.肝癌患者肝移植术后医院感染病原菌分布及耐药性分析[J].中华医院感染学杂志,2014,24(3):588-590