伊曲康唑间歇冲击疗法治疗甲真菌病的血清及甲中药物水平的研究

目的 了解伊曲康唑间歇冲击疗法治疗甲真菌病的血清及甲中药物水平的变化，为该疗法提供药物动力学依据。方法 １５例趾甲真菌病患者经伊曲康唑间歇冲击疗法治疗；于服药前、服药后每月取患者血清（共３月）并收集远端甲标本，将指甲和趾甲分开；以高效液相色谱（ＨＰＬＣ）测定伊曲康唑的含量。结果 １．每次冲击后４周，血清中均未测得伊曲康唑；２．甲组织中伊曲康唑水平较高，在２或３月时达到高峰；３．停药后，伊曲康唑仍能以较高的水平在甲中存在至６月后；同一时间点，指甲和趾甲中的药物水平无统计学差异（Ｐ〉０．０５）。结论 伊曲康唑经口服吸收后从血液迅速向甲组织分布，停药后，以较高水平在甲组织中持续存在６月以上。

Levels of Itraconazole in Serum and Nail Samples of Toenail Onychomycosis by Intermittent Pulse Therpy

Objective To Obtain the information on the levels of itraconazole in nail of toenail onychomycosis patients who were treated with itraconazole intermittent pulse therapy. Methods 15 patients with toenail onychomycosis were treated for three pulses of 1- week itraconazole therapy, Serum and distal nail clipings were taken from patients before initiation of therapy and 1, 2,3months later, respectively. The levels of itraconazole in nails and in serum samples were measured by high performance liquid chromatography (HPLC ). Results 1. Itraconazole could not be detected in serum samples at the forthe week of each pulse thera- py; 2. The levels of itraconazole in nails could get to peak value in 2 - 3 month; 3. Itraconazole could persist in nails for more than 6 months after cessation of treatment; 4. The levels of itraconazole in fingernail had no differences statistically compared with that in toenail. Conclusion Itraconazole could rapidly distribute into nail tissue from blood cycle and persist there more than 6 months after the discontinuation of treatment.