连续性静脉-静脉血液滤过患者血清中利奈唑胺的浓度监测

目的:对连续性静脉-静脉血液滤过(continuous venovenous hemofiltration,CVVH)治疗的危重患者进行利奈唑胺血药浓度监测,为临床个体化治疗提供依据。方法:建立高效液相色谱法(以左氧氟沙星为内标),测定患者血清中利奈唑胺谷浓度。结果:利奈唑胺在0.31～20.00μg.mL-1内线性关系良好(r=0.999 5),定量限为0.31μg.mL-1。5例危重患者在治疗期间监测23次的利奈唑胺谷浓度变化明显,变化范围为1.53～17.10μg.mL-1。有2例患者谷浓度变化较大(相差近5倍)。结论:高效液相色谱法简单、快速、准确、灵敏、重复性好,可用于临床利奈唑胺的血药浓度监测。进行连续性静脉-静脉血液滤过治疗的患者,应用利奈唑胺时血药浓度变化较大,需要通过治疗药物监测的方法制定个体化给药方案。

Determination of serum linezolid concentration in critically ill patients during continuous veno-venous hemofiltration

OBJECTIVE To monitor the serum linezolid trough concentration in critically ill patients with continuous venovenous hemofiltration(CVVH),in order to make individualized treatment regiment for these patients.METHODS A method was established for determining linezolid in human serum by HPLC(internal standard method).RESULTS A good linearity was demonstrated between 0.31-20.00 μg·mL-1(r=0.999 5),the lowest limit of quantification of 0.31 μg·mL-1.The relative recovery was 99.12%.Linezolid serum concentrations changed significantly in the five patients during CVVH,with the trough concentration range of 1.53-17.10 μg·mL-1.The linezolid trough concentration in two patients showed changing greatly(nearly 5-fold).CONCLUSION The method is simple,rapid,accurate,sensitive,reproducible,and validated for determination of serum linezolid in patients.Linezolid serum concentrations in critically ill patients during continuous venovenous hemofiltration showed significant variability.Drug concentration should be monitored in those patients in order to make individual regiment of linezolid in clinical practice.