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目的 :量化地研究培氟沙星 (PFL X)及其代谢产物诺氟沙星 (NFL X)对肺阻塞性疾病患者氨茶碱 (Ami)药物动力学的影响。方法 :18例慢性阻塞性肺疾病 (COPD)患者 po Ami10 0 mg,q8h,d4起第 组 (9例 )加服 PFL X40 0 mg,q12 h;第 组 (9例 )加服 NFL X40 0 m g,q12 h。至 d9,以高效液相色谱色 (HPL C)平行监测合用前后茶碱 (Theo)的经时血浓 ,拟合 Theo药物动力学参数并做统计学比较。结果 :与合用前相比 ,第 组患者血清中 Theo浓度显著增高 (P<0 .0 5 ) ,消除半衰期非常显著性延长 (P<0 .0 1) ,清除率显著下降 (P<0 .0 5 ) ;第 组患者血清中 Theo浓度也有所增加 ,消除半衰期相应延长 ,清除率相应减少 ,但均无统计学差异 (P>0 .0 5 )。结论 :合用 PFL X对 Am i的消除动力学有显著性抑制 ,临床合用时应注意 Theo的血浓监测 ,防止 Am i因代谢减慢而引起蓄积中毒 :NFL X与 Ami合用则相对安全。
OBJECTIVE: To quantitatively study the pharmacokinetics of aminophylline (Ami) in patients with pulmonary obstructive disease (PFI) and its metabolite norfloxacin (NFL X). Methods: A total of 18 patients with chronic obstructive pulmonary disease (COPD) received po Amil 10 mg, q8h and d4 from the first group (n = 9) received PFL X40 0 mg for q12 h. The first group (n = 9) received NFL X40 0 mg , q12 h. At d9, the elapsed blood concentration of theophylline (Theo) before and after the combination was monitored by high performance liquid chromatography (HPL C) in parallel. The pharmacokinetic parameters of Theo were fitted and statistically compared. Results: Compared with the pre-combination group, the serum concentration of Theo in the patients in the first group was significantly increased (P <0.05), the elimination half-life was significantly prolonged (P <0.01), and the clearance rate was significantly decreased (P <0. The concentration of Theo in the serum of the patients in the first group also increased, the elimination half-life prolonged and the clearance rate decreased correspondingly, but there was no significant difference (P> 0.05). Conclusion: The combination of PFL X has a significant inhibitory effect on the elimination kinetics of Am i. At the same time, we should pay attention to the blood concentration monitoring of Theo in order to prevent accumulation of poisoning caused by the slow metabolism of Ami. The combination of NFL X and Ami is relatively safe.