伊米配能在烧伤急性期的药代动力学研究

目的　研究伊米配能 /西司他丁在烧伤急性期患者应用时的药代动力学特点。　方法　 6名烧伤急性期患者 (P组 )第一次给药后 ,利用高效液相色谱分析技术测定其血浆、水疱液、痂下组织、尿液中伊米配能浓度 ,计算药代动力学参数 ;另选 10名健康志愿者为对照组 (C组 )。结果同C组相比 ,P组的药代动力学参数发生明显改变。表现为半衰期延长 :C组 (1.0 6± 0 .2 4)h、P组 (1.5 6±0 .5 5 )h ;分布容积增大 :C组 (13.96± 7.10 )、P组 (16 .16± 4.2 6 )。第一次给药后 1h即能测出P组水疱液和痂下组织中伊米配能浓度 ,分别为 (8.17± 1.6 9) μg/ml、(12 .14± 2 .72 ) μg/g。伊米配能的肾清除率与患者肌酐清除率呈正相关 (r =0 .5 834)。　结论　急性期应用负荷剂量的伊米配能 /西司他丁时应延长用药间隔时间 ;早期应用伊米配能 /西司他丁可穿透II度、III度烧伤组织 ;临床用药时应注意观察肾功能情况

Study onthe pharmacokinetics of Imipenem cilastatin in burn patients during the acute phase

OBJECTIVE: To investigate the pharmacokinetic characteristics of Imipenem/cilastatin in burn patients during the acute phase. METHODS: Imipenem concentrations in the plasma, blister and, interstitial fluids and urine of 6 burn patients (P group) were determined during the acute phase by high performance liquid chromatography after the first initial dose. Pharmacokinetic parameters were thus produced and statistically analyzed by program package STAT 5. Ten healthy volunteers served as control group (C group). RESULTS: Compared to those in control group, pharmacokinetic parameters of Imipenem exhibited evident difference, such as prolonged half-life [(1.56 plus minus 0.55) h vs (1.06 plus minus 0.24) h] and enlarged distributing volume (16.16 plus minus 4.26) vs (13.96 plus minus 7.10). Imipenem could be detected in the blister and interstitial fluids of burn patients 1 hr after the initial dose. Renal clearance of Imipenem was positively correlated to creatinine clearance (r = 0.5834). CONCLUSION: The intervals between doses should better be prolonged when loaded-dosage of Imipenem was administered in burn patients during the acute phase. Imipenem could penetrate II and III degree burn wound when given in the acute phase. Attention should be paid to renal function when Imipenem was given.