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目的 探讨甲硝唑及替硝唑在人胆汁中的代谢特点 ,为临床用药提供理论依据。方法 通过临床行逆行胰胆管造影+鼻胆管引流直接获取胆汁 ,利用高效液相色谱法 ,连续动态监测给药后血液及胆汁内两种抗生素的浓度变化和代谢特点。结果一次性给药 0 2 5h后两种抗生素在胆汁内即可达到有效杀菌浓度 ,替硝唑在胆汁内药物浓度较平稳 ,但峰浓度不如甲硝唑高 ,在2 4h内两种抗生素胆汁内浓度高于有效杀菌浓度 ,16h后药物浓度有回升现象。结论 甲硝唑及替硝唑为抗胆道厌氧菌感染的最佳抗生素选择 ,对一般感染可每日一次给药 ,对重症感染可选择甲硝唑 ,增加给药次数
Objective To investigate the metabolic characteristics of metronidazole and tinidazole in human bile and to provide a theoretical basis for clinical use. Methods The bile was directly obtained through the clinical retrograde cholangiopancreatography and nasobiliary drainage. The concentrations and metabolic characteristics of two antibiotics in the blood and bile were continuously and dynamically monitored by high performance liquid chromatography. The results showed that the two antibiotics could reach the effective bactericidal concentration within the bile after one-time administration. The drug concentration of tinidazole in bile was relatively stable, but the peak concentration was not as high as that of metronidazole. Within 24 hours, the two antibiotics bile Concentration higher than the effective bactericidal concentration, 16h after the drug concentration rebound phenomenon. Conclusions Metronidazole and tinidazole are the best antibiotics for anti-bile anaerobic infections. They can be given once a day for general infection and metronidazole for severe infections,