271.)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.docVIP

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 杨华1,3，董海燕1，董亚琳1* 1. 西安交通大学医学院第一附属医院药学部，陕西 西安 710061； 2. 西安交通大学医学院第一附属医院中心ICU；3. 西安市红十字会医院，陕西 西安 710054 [摘要] 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0.31～20.00?g·ml-1内线性关系良好（r = 0.9995），定量限为0.31 ?g·ml-1，方法回收率为99.12％。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1.53-17.10 ?g·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、重现性好，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。 [关键词] 利奈唑胺；高效液相色谱法；治疗药物监测；连续性静脉-静脉血液滤过；个体化治疗 [中图分类号] R978.1 [文献标识码] A [文章编号] Determination of serum linezolid concentration in critically ill patients during continuous veno-venous hemofiltration YANG Hua1,3, DONG Hai-yan1, YOU Hai-sheng1, WANG Xue2, LI Hao2, DONG Wei-hua1，DONG Ya-lin1* ( 1.The First Affiliated Hospital, School of Medicine, Xi’an Jiaotong University,Shanxi Xi’an 710061; 2. The First Affiliated Hospital, ICU, Jiaotong University, Shanxi Xi’an 710061;3. Xi’an Red Cross Hospital, Shanxi Xi’an 710054) 基金项目：西安交通大学医学院第一附属医院院基金（编号2008YK28）作者简介：杨华，硕士研究生，E-mail：通讯作者：董亚琳，博士，主任药师，电话：029E-mail:Abstract: 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 To establish a method of determining serum linezolid in human by HPLC (internal standard method). Result A good linearity was demonstrated between 0.31 – 20.00?g·ml-1 ( r = 0.9995), the lowest limit of quantification of 0.31?g·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 ?g·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