微透析技术在肿瘤药物研究中的应用进展

微透析技术具有连续动态微创取样优势,能实时在线研究正常生理和肿瘤病理情况下肿瘤药物在体内,尤其是肿瘤组织局部的分布、代谢和消除,利用PK/PD参数模型设计个体化给药方案,预防和减少肿瘤药物的毒性反应。同时,微透析技术还可以应用于肿瘤细胞外间质微环境中生化物质的监测以及肿瘤药物局部给药治疗,是肿瘤药物研究的重要技术手段。本文对近年来微透析在肿瘤药物研究中的应用进展进行检索和归纳,为微透析技术在取样、监测以及治疗领域的进一步研究应用提供参考。     

用在体皮肤微透析法研究黄芩苷凝胶经大鼠皮肤吸收的局部药动学

目的建立大鼠在体皮肤微透析技术,研究黄芩苷凝胶经皮吸收局部药动学。方法采用HPLC-MS/MS联用技术测定大鼠皮肤微透析液中黄芩苷的浓度。SD大鼠在麻醉状态下做皮肤微透析预处理,然后将黄芩苷凝胶涂于探针所在皮肤表面,收集皮肤微透析液样品进行黄芩苷浓度测定,绘制黄芩苷浓度-时间曲线,计算经皮吸收局部药动学参数。结果用于定量分析的离子对为m/z 447.3→271.2,黄芩苷在检测浓度范围内线性关系良好,色谱的专属性、精密度等测定结果均符合生物样品测定要求。体内皮下探针对黄芩苷的回收率为（24.40±0.91）%,240 min内各取样点回收率保持稳定;黄芩苷经皮给药后8 h内微透析液中均可检测到黄芩苷的存在,且药物在皮肤组织内浓度持续升高,AUC0-t为（50.04±34.17）（mg·min）/L。结论在体皮肤微透析法可用于黄芩苷经皮吸收局部药动学研究。     

微透析技术用于化疗药物——吉西他滨体内药动学的初步研究

目的：建立以微透析法（microdialysis,MD）为采样技术的肿瘤化疗药物在体检测方法,并进行药动学研究。方法：以吉西他滨（GEM）为研究对象,大鼠为实验动物,采用尾静脉注射为给药方式,通过微透析技术进行血管内取样,对血药浓度进行在线、实时、连续监测,求算相关药动学参数。结果：GEM在大鼠体内血液中的探针回收率为（11.9±2.0）%,经大鼠尾静脉给药后GEM体内过程为二室模型,其消除和分布为一级动力学过程。实验过程中大鼠未见明显副作用。结论：微透析技术可用于活体动物体内GEM浓度的连续监测,提示微透析技术可用于抗肿瘤药物的局部药动学研究。     

基于微透析技术的苦参碱凝胶经皮给药的药动学研究

目的 建立同步测定经皮给药制剂在皮肤、血液中药动学的方法,研究苦参碱凝胶在体内的药动学行为。方法 应用经体外和体内回收率校正建立的基于微透析探针的皮肤血液双位点同步微透析系统,通过在皮肤和颈静脉植入探针,在大鼠腹部脱毛部位给予苦参碱凝胶,连续收集探针中12 h的透析液,并采用LC-MS微量检测技术测定探针透析液中的药物浓度。结果 本研究成功构建了双位点同步微透析药动学评价系统,大鼠皮肤给予苦参碱凝胶后,皮肤中的药物浓度、AUC值、半衰期均显著高于血液中药物浓度。结论 本研究建立的微透析结合LC-MS的取样及检测技术为经皮给药制剂的药动学研究提供了新的技术平台。     

脑微透析在药物监测中的应用

脑微透析是一种微创取样技术,具有多位点、实时取样和可在线等优点,在脑部药物监测中越来越受到关注。脑微透析技术为脑部药物浓度的监测提供了一种有效的新途径,可为新药研发与临床合理用药提供科学依据,在脑部给药系统研究中,特别是药动学及药效学研究中优势显著,具有很好的应用前景。本文综述了有关脑部微透析技术的特点及发展,介绍了脑微透析技术在药物监测研究中的进展,分别归纳了微透析技术在实验动物和临床患者中的应用情况。     

微透析技术在抗菌药物药动学和药效学中的应用

微透析技术是一项新兴的体内药物分析技术。通过微透析技术与药动学和药效学模型结合,实现对组织或细胞外游离态药物浓度及其相应药理效应的同时研究,不仅有利于进一步明确药物的剂量-效应关系,制定临床最佳给药方案,而且也为个体化给药提供了科学依据。本文综合近年文献,对微透析技术的基本原理以及在抗菌药物药动学和药效学研究中的应用作一综述。     

微透析技术应用于Gefitinib药动学采样的可行性研究

目的：本研究旨在考察微透析采样技术用于Gefitinib体内药动学研究的可行性,为后续探讨Gefitinib肿瘤局部药动学及药效学研究奠定方法学基础。方法： 采用浓差法（增量法、减量法）测定Gefitinib体外回收率（RG）及释放率（RL）,探讨流速、pH、浓度、温度对回收率的影响,及体内外回收率与释放率的稳定性,建立Gefitinib微透析采样方法。结果： 反透析法测得Gefitinib的RG与RL呈良好一致性,与灌流液pH及探针外液温度存在线性关系,对浓度变化保持恒定,且体内外日内RG与RL稳定性良好。结论：微透析采样技术可以实现Gefitinib体内药物浓度动态监测,研究所得微透析采样参数可为该法进行Gefitinib肿瘤局部药动学研究提供参考。     

利用稳定同位素内标微透析技术进行尼古丁脑局部药动学研究

采用以稳定同位素为内标的微透析技术,研究清醒自由活动下大鼠脑局部药动学过程。健康SD大鼠为研究对象,以尼古丁(nicotine)为模型药物,以氘代尼古丁(deuterium labeled nicotine,DL-nicotine)为微透析(microdialysis,MD)的内标物。样品采用LC-MS/MS法检测,同时测定透析液中尼古丁及DL-尼古丁的浓度。数据分析采用DAS2.0软件。经皮给予尼古丁后,大鼠脑局部尼古丁的吸收和分布过程符合二室模型,其中t1/2α为170.31 min,t1/2β为263.30 min,AUC0-∞为2.75×105μg.L-1.min。DL-尼古丁可作为尼古丁的内标物进行探针回收率的校正;稳定同位素内标微透析技术可实现尼古丁在清醒状态大鼠脑局部药动学的研究,为戒烟方法的寻找及尼古丁经皮制剂的药动学-药效学相结合的研究提供了新思路。     

微透析采样技术在抗乳腺癌药物研究方面的应用

目的:介绍微透析采样技术在抗乳腺癌药物方面的研究与应用现状。方法:参阅国内外文献,进行分析、归纳和总结。结果:微透析采样技术在乳腺癌的发病机制、乳腺癌药物临床前和临床药理及药动学、PK-PD结合模型、联合用药合理性等方面研究应用广泛。结论:微透析采样技术结合现代成像技术,在乳腺癌肿瘤局部药动学研究方面具有广阔的应用前景。     

微透析技术在药物靶组织分布和代谢研究中的应用

微透析技术是一项新兴的在体研究技术，近年来已广泛应用于药物在靶组织分布和代谢研究，对于阐明药物体内过程、疗效和安全性有重要意义，为新药研发与临床合理用药提供科学依据。现通过检索分析相关文献，就微透析技术的概况、微透析探针、透析液的分析及微透析技术在药物靶组织分布和代谢研究中的应用作一综述。     

Development of an in vitro dissolution method using microdialysis sampling technique for implantable drug delivery systems.

The major challenge faced during the development of implantable dosage forms for site-specific delivery is monitoring the local concentration of the drug at or around the site of action. The tissue concentration at the site is generally measured by either sacrificing the animal at different points in time or by determining the amount of drug left in the implants at various time intervals. Unfortunately, there are no official in vitro dissolution methods available to study the release characteristics of drugs from this drug delivery system. The objective of this investigation was to develop a simple method using microdialysis sampling technique to serve as an in vitro dissolution method for implantable drug delivery systems. Ciprofloxacin implants were prepared by compressing ciprofloxacin microcapsules in poly(lactic acid) (PLA) and poly(lactic-glycolic acid) (PLGA). A sensitive HPLC method was developed and validated for the assay of Ciprofloxacin. An in vitro dissolution method was developed to study the release characteristics of drug from these implants. The method used a microdialysis sampling technique and a small sample volume of release medium. The various advantages and disadvantages of this method over other USP methods are discussed.     

Microdialysis as a tool in local pharmacodynamics

In many cases the clinical outcome of therapy needs to be determined by the drug concentration in the tissue compartment in which the pharmacological effect occurs rather than in the plasma. Microdialysis is an in vivo technique that allows direct measurement of unbound tissue concentrations and permits monitoring of the biochemical and physiological effects of drugs throughout the body. Microdialysis was first used in pharmacodynamic research to study neurotransmission, and this remains its most common application in the field. In this review, we give an overview of the principles, techniques, and applications of microdialysis in pharmacodynamic studies of local physiological events, including measurement of endogenous substances such as acetylcholine, catecholamines, serotonin, amino acids, peptides, glucose, lactate, glycerol, and hormones. Microdialysis coupled with systemic drug administration also permits the more intensive examination of the pharmacotherapeutic effect of drugs on extracellular levels of endogenous substances in peripheral compartments and blood. Selected examples of the physiological effects and mechanisms of action of drugs are also discussed, as are the advantages and limitations of this method. It is concluded that microdialysis is a reliable technique for the measurement of local events, which makes it an attractive tool for local pharmacodynamic research.     

Free drug concentration monitoring in clinical practice. Rationale and current status

Recent advances in techniques to determine free drug concentrations have lead to a substantial increase in the monitoring of this parameter in clinical practice. The majority of drug binding to macromolecules in serum can be accounted for by association with albumin and alpha 1-acid glycoprotein. Albumin is the primary binding protein for acidic drugs, while binding to alpha 1-acid glycoprotein is more commonly observed with basic lipophilic agents. Alterations in the concentrations of either of these macromolecules can result in significant changes in free fraction. Diseases such as cirrhosis, nephrotic syndrome and malnourishment can result in hypoalbuminaemia. Burn injury, cancer, chronic pain syndrome, myocardial infarction, inflammatory diseases and trauma are all associated with elevations in the concentration of alpha 1-acid glycoprotein. Treatment with a number of drugs has also been shown to increase alpha 1-acid glycoprotein serum concentrations. A wide variety of biological fluids have been examined for their ability to provide an estimation of free drug concentration at receptor sites. The most useful fluid for estimating free drug concentrations appears to be plasma or serum, with subsequent treatment of the sample to separate free and bound drug by an appropriate technique. The two most widely used methods are equilibrium dialysis and ultrafiltration. Of these two, ultrafiltration has the greatest utility clinically because it is rapid and relatively simple. The major difficulty associated with this method involves the binding of drug to the ultrafilters, but significant progress has been made in solving this problem. Several authors have endorsed the routine use of free drug concentration monitoring. Data examining the clinical usefulness of free drug concentration monitoring for phenytoin, carbamazepine, valproic acid, disopyramide and lignocaine (lidocaine) are reviewed. While available evidence suggests that free concentrations may correlate with clinical effects better than total drug concentrations, there are insufficient data to justify the recommendation of the routine use of free drug concentration monitoring for any of these agents at present.     

治疗药物监测的研究进展

本文从临床开展治疗药物监测药物种类的变化、分析监测方法技术和交叉学科的发展等多个方面阐述了近年来治疗药物监测学科的研究进展。液质联用和免疫检测法是临床常用方法,准确、快速、经济的检测方法是未来技术发展的重点,药物基因组学、游离药物浓度监测技术和群体药动学（PPK）将成为未来治疗药物监测领域重要的发展方向。     

Bioanalysis of racemic reboxetine and its desethylated metabolite in a therapeutic drug monitoring setting using solid phase extraction and HPLC

Reboxetine is a new antidepressant drug acting as a potent and selective noradrenaline reuptake inhibitor on the noradrenergic neuronal system. Because of an expected interindividual variability in drug metabolism in the clinical practice the need for therapeutic drug monitoring routines in psychiatry is always a prominent feature. In this application, the preferred bioanalytic methodology was solid phase extraction combined with reversed-phase high-performance liquid chromatography and ultraviolet detection at 210 nm. The technique proved reliable, with interday and intraday variation of less than 5% and a quantification limit for reboxetine and one of its main metabolites O-desethylreboxetine (O-reboxetine) at 5 and 30 nmol/L, respectively. The method was applied on serum samples from 38 patients treated chronically with reboxetine. These samples were drawn as trough levels in steady state with a dosage range of 2-16 mg/day. They evidenced a mean reboxetine concentration that was fairly linear and dose proportional, although the variance in concentration was large between patients, even those taking the same dosage. O-reboxetine was detected in quantifiable amounts in only 1 of the 38 patients (<3%). In conclusion, these results suggest that a routine reboxetine therapeutic drug monitoring service that is robust enough to produce reliable and reproducible results may be introduced into everyday clinical practice.     

酶放大免疫测定法监测丙戊酸血药浓度的结果分析

目的：通过对癫痫患者的342例次丙戊酸血药浓度监测结果分析,为临床合理用药提供参考。方法：采用酶放大免疫法检测丙戊酸血药浓度,对173例患者的342例次血药浓度进行分析,并观察其临床疗效和不良反应。结果：在342例次癫痫患者丙戊酸血药浓度监测结果中,测定值在50～100μg/ml的有150例次（占43．86％）,〈50μg/ml的有159例次（占46．49％）,〉100μg/ml的有33例次（占9．65％）。结论：丙戊酸治疗癫痫的临床疗效及不良反应与血药浓度密切相关,对丙戊酸血药浓度进行监测的结果是指导临床用药的重要依据之一,临床治疗过程中加强丙戊酸的血药浓度监测是保证疗效和安全的重要措施。     

Application of intracerebral microdialysis to study regional distribution kinetics of drugs in rat brain.

1. The purpose of the present study was to determine whether intracerebral microdialysis can be used for the assessment of local differences in drug concentrations within the brain. 2. Two transversal microdialysis probes were implanted in parallel into the frontal cortex of male Wistar rats, and used as a local infusion and detection device respectively. Within one rat, three different concentrations of atenolol or acetaminophen were infused in randomized order. By means of the detection probe, concentration-time profiles of the drug in the brain were measured at interprobe distances between 1 and 2 mm. 3. Drug concentrations were found to be dependent on the drug as well as on the interprobe distance. It was found that the outflow concentration from the detection probe decreased with increasing lateral spacing between the probes and this decay was much steeper for acetaminophen than for atenolol. A model was developed which allows estimation of kbp/Deff (transfer coefficient from brain to blood/effective diffusion coefficient in brain extracellular fluid), which was considerably larger for the more lipohilic drug, acetaminophen. In addition, in vivo recovery values for both drugs were determined. 4. The results show that intracerebral microdialysis is able to detect local differences in drug concentrations following infusion into the brain. Furthermore, the potential use of intracerebral microdialysis to obtain pharmacokinetic parameters of drug distribution in brain by means of monitoring local concentrations of drugs in time is demonstrated.     

临床药师对婴幼儿万古霉素血药浓度监测情况分析(英文)

临床药师对2013–2014年婴幼儿病区使用万古霉素的患儿进行血药浓度监测,根据监测结果进行调整用药剂量。此文章对监测结果进行分析总结,讨论万古霉素在新生儿中监测的必要性以及临床药师在此过程中发挥的作用。分析表明,对新生儿常规进行万古霉素血药浓度监测极其必要,而临床药师对使用万古霉素的患儿进行用药监护,参与到临床治疗方案调整当中,可以增加万古霉素使用的有效性及预防不良反应的发生,是一种新型的治疗模式。     

2015年某院治疗药物浓度监测结果回顾性分析

目的：回顾性分析某院患者血药浓度监测数据,探讨血药浓度监测在临床合理用药的作用。方法：对某院2015年9种治疗药物监测数据进行回顾性分析,包括监测品种的构成情况,测定频率情况,监测比例情况以及各个监测品种的监测结果及科室分布情况。结果：该院监测例数和测定频率最多的是免疫抑制剂环孢霉素A,占我院所有监测品种次数的80.3%,其次是甲氨蝶呤和他克莫司。他克莫司、甲氨蝶呤、环孢素A和地高辛监测比例均达到60%以上。90.1%儿科患者的42 h甲氨蝶呤血药浓度分布在0.1~1 μmol·L^-1。抗癫痫药物中监测次数最多的是丙戊酸,但多数仅监测一次,说明医师和患者对抗癫痫药物的血药浓度的重视程度不够。万古霉素和地高辛用药人群为老年人,建议将血药浓度调整在正常范围的中下限。结论：血药浓度"正常"的构成比较高,说明该院临床医师已充分意识到治疗药物监测的重要性,此外仍需要医师与临床药师密切配合,根据血药浓度监测结果,调整给药方案,有效提高治疗成功率。