骨水泥载万古霉素超声低频脉冲型治疗的起始时间对药动药效产生的影响分析

发布时间：2018-01-14 20:02

本文关键词：骨水泥载万古霉素超声低频脉冲型治疗的起始时间对药动药效产生的影响分析　出处：《中国医院药学杂志》2015年03期 　论文类型：期刊论文

【摘要】：目的:研究低频脉冲超声治疗的起始时间对载万古霉素骨水泥的药物动力学、药效释放以及抗菌活性的影响。方法:选择50只健康大鼠,在大鼠髋关节均植入载万古霉素的骨水泥以及标准金黄色葡萄球菌(ATCC13565,中国生物鉴定研究所),随后将50只大鼠随机分成观察组、对照组,观察组在植入后12 h进行低频超声治疗,对照组在植入后30 min进行低频超声治疗,两组均治疗12 h后取4只大鼠测定髋关节内的渗血量,其余大鼠测定髋关节内的药物浓度,计算药物动力及药效参数,在植入48 h后计数髋关节腔内的活菌量并进行组间比较。结果:观察组、对照组均在植入3 h后达到药物浓度高峰,对照组3 h后药物浓度呈明显的下降态势,并在14 h后下降到MIC以下,观察组在3 h后也呈下降态势,但在12 h采用低频超声治疗后,药物浓度再次上升,并一直持续在MIC以上至第34小时;观察组Cmax/MIC(5.58±1.86)明显低于对照组的(14.81±2.41),差异具有统计学意义(P0.05);观察组Tmic(35.08±5.98)h明显高于对照组的(13.49±1.49)h,差异具有统计学意义(P0.05);对照组菌落数、渗血量明显高于观察组(P0.05)。结论:与植入后立即进行超声治疗相比,在第12小时进行治疗能够有效提高血液的Tmic,提高载万古霉素骨水泥的抗菌作用。
[Abstract]:Objective: to study the effect of the initial time of low-frequency pulsed ultrasound on pharmacokinetics, pharmacokinetics, release and antibacterial activity of bone cement loaded with vancomycin. Methods: 50 healthy rats were selected. Bone cement loaded with vancomycin and standard staphylococcus aureus ATCC 13565 were implanted into the hip joints of the rats, and then 50 rats were randomly divided into observation group. The control group was treated with low-frequency ultrasound 12 hours after implantation, while the control group was treated with low-frequency ultrasound 30 min after implantation. After 12 hours of treatment, 4 rats in both groups were taken to determine the amount of blood oozing in the hip joint, and the other rats measured the drug concentration in the hip joint, and calculated the pharmacokinetic and pharmacodynamic parameters. After 48 hours of implantation, the live bacteria in the hip joint were counted and compared among the groups. Results: in the observation group and the control group, the concentration of the drug reached the peak 3 h after implantation. The drug concentration in the control group decreased significantly after 3 h, and decreased below MIC after 14 h, and decreased in the observation group after 3 h, but after 12 h treatment with low frequency ultrasound. The drug concentration increased again and lasted from above to 34 hours after MIC. Cmax/MIC(5.58 卤1.86 in the observation group was significantly lower than that in the control group (14.81 卤2.41), and the difference was statistically significant (P 0.05). The Tmic(35.08 of the observation group was significantly higher than that of the control group (13.49 卤1.49 h), and the difference was statistically significant (P 0.05). The number of colony in the control group was significantly higher than that in the observation group (P 0.05). Conclusion: compared with the ultrasound treatment immediately after implantation, the Tmic of blood can be effectively increased after 12 hours of treatment. The antibacterial effect of vancomycin loaded bone cement was improved.
【作者单位】：山西医科大学药学院;北京大学肿瘤医院暨北京市肿瘤防治研究所药剂科;山西医科大学第一临床医院;
【分类号】：R965
【正文快照】： 术后关节感染是人工髋关节置换术常见的并发症,严重威胁植入关节的功能,全身大剂量使用抗生素不能有效地提高抗生素在髋关节部位的局部浓度,还可能产生耐药和肾毒性[1]。抗生素骨水泥技术是1970年Buchholz等首次尝试应用于控制关节感染,将抗生素混合于用于植入的骨水泥铸件中,

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