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目的 研究培氟沙星在老年肺炎同时伴有肾功能不同程度障碍患者中的血、痰药物浓度 ,临床效果及药物毒性。方法 按肾功能障碍程度分 4组 ,均以培氟沙星 40 0mg静脉滴注 ,间隔 12h 1次 ,疗程 10d。记录临床表现、实验室指标 ;生物法测定用药后血、痰中药物浓度 ,进行对比分析。结果 4组患者血及痰药物浓度依肾功能障碍程度而不同。肾功能正常及轻度障碍组 ,血药浓度与痰药浓度接近 ,临床有效率分别是 83 %及 80 % ,细菌清除率均为 86 %。肾功能中度及重度障碍组血药浓度与痰药浓度随肾功能障碍加重而差距增大 ,临床有效率分别为 6 6 %及 5 3% ,细菌清除率分别为 5 7%及 36 % ,不良反应增多 ,该药对中、重度肾功能障碍者有肾毒性。结论 中度肾功能障碍者应用该药时应改善肾功能及延长给药间隔 ,重度肾功能障碍者应避免使用
Objective To study the blood, phlegm drug concentration, clinical effect and drug toxicity of pefloxacin in elderly patients with pneumonia and different degrees of renal dysfunction. Methods According to the degree of renal dysfunction, the patients were divided into 4 groups, all of them were intravenously infused with pefloxacin 40 0 mg once every 12 hours for 10 days. Record clinical manifestations, laboratory indicators; biological assay after treatment of blood, sputum drug concentration, comparative analysis. Results The concentrations of blood and sputum in 4 groups of patients differed according to the degree of renal dysfunction. Normal renal function and mild dysfunction group, the concentration of blood concentration and phlegm close, the clinical efficiency were 83% and 80%, respectively, the bacterial clearance rate was 86%. Serum and sputum concentrations of patients with moderate and severe renal dysfunction increased with the increase of renal dysfunction. The clinical effective rates were 66% and 53% respectively, and the bacterial clearance rates were 57% and 36% respectively. Adverse reactions increased, the drug on the moderate and severe renal dysfunction were renal toxicity. Conclusion The application of this medicine in patients with moderate renal dysfunction should improve renal function and prolong the interval of administration. Patients with severe renal dysfunction should avoid using