2018 年第 7 期 第 13 卷

美罗培南对丙戊酸钠稳态血药浓度的影响

Effect of meropenem on steady state plasma concentration of sodium valproate

作者：赵婷王晓雯李红健鲍思臣王婷婷玛尔江·巴哈提别克孙力于鲁海

英文作者：

单位：830001乌鲁木齐，新疆维吾尔自治区人民医院药学部

英文单位：

关键词：美罗培南；丙戊酸钠；血药浓度

英文关键词：

• 摘要：

• 【摘要】目的    探讨美罗培南对丙戊酸钠稳态血药浓度的影响，为临床合理用药提供参考。方法    选择新疆维吾尔自治区人民医院2015年1月至2017年9月联合应用美罗培南和丙戊酸钠并监测丙戊酸钠稳态血药浓度的27例住院患者，分析合用美罗培南前后丙戊酸钠血药浓度的变化及其变化幅度。结果    27例患者在合用美罗培南前丙戊酸钠血药浓度均达到治疗浓度（50~100 mg/L）,合用美罗培南后其血药浓度为2～28 mg/L,均降到治疗浓度范围以下,下降幅度为（78±15）%，与合用美罗培南前比较明显降低［（15±10）mg/L比(71±18)mg/L］，差异有统计学意义（t=15.408，P<0.001）。依据合用美罗培南前丙戊酸钠血药浓度将27例患者分为50～60 mg/L组（9例）、>60～70 mg/L组（8例）、＞70 mg/L组（10例），3组患者合用美罗培南后丙戊酸钠血药浓度均低于合用前［(9±6)mg/L比(51±7)mg/L，(15±5)mg/L比(66±3)mg/L，(15±11)mg/L比(88±13)mg/L］（均P<0.05），但3组间下降幅度比较差异无统计学意义（P>0.05）。依据丙戊酸钠用法用量将27例患者分为0.25 g、3次/d组（6例），0.4 g、3次/d组（13例），0.5 g、2次/d组（8例），3组患者合用美罗培南后丙戊酸钠血药浓度均低于合用前［(7±6)mg/L比(64±20)mg/L，(16±12)mg/L比(74±20)mg/L，(15±9)mg/L比(71±16)mg/L］（均P<0.05），但3组间下降幅度比较差异无统计学意义（P>0.05）。结论    美罗培南与丙戊酸钠联合用药可使丙戊酸钠血药浓度显著降低，临床上应避免二者联用。

• 【Abstract】Objective    To analyze the effect of meropenem on the steady state plasma concentration of sodium valproate. Methods    Twenty-seven in-patients taking meropenem and sodium valproate in People′s Hospital of Xinjing Uygur Autonomous Region were enrolled from January 2015 to September 2017. Steady state plasma-sodium valproate concentration was monitored; changes of the plasma-sodium valproate concentration after taking meropenem were analyzed. Results    Steady state plasma-sodium valproate concentration in 27 patients was 50-100 mg/L before taking meropenem and it decreased to 2-28 mg/L after taking meropenem, which was below the therapeutic concentration range; the drop range was （78±15）%; the mean steady state plasma-sodium valproate concentration after taking meropenem was significantly lower than that before taking meropenem［（15±10）mg/L vs (71±18)mg/L］(t=15.408, P<0.001). According to plasma-sodium valproate concentration before taking meropenem, 27 patients were divided into 50-60 mg/L group（n＝9）, >60-70 mg/L group（n＝8） and >70 mg/L group（n＝10）; the mean steady state plasma-sodium valproate concentration after taking meropenem was significantly lower than that before taking meropenem in all 3 groups［(9±6)mg/L vs (51±7)mg/L， (15±5)mg/L vs (66±3)mg/L， (15±11)mg/L vs (88±13)mg/L］(P<0.05); the drop range showed no significant difference among groups(P>0.05). According to dosage of sodium valproate, 27 patients were divided into 0.25 g, 3 times/d group（n＝6）, 0.4 g, 3 times/d group（n＝13） and 0.5 g, 2 times/d group（n＝8）; the mean steady state plasma-sodium valproate concentration after taking meropenem was significantly lower than that before taking meropenem in all 3 groups［(7±6)mg/L vs (64±20)mg/L， (16±12)mg/L vs (74±20)mg/L， (15±9)mg/L vs (71±16)mg/L］（P<0.05）; the drop range showed no significant difference among groups(P>0.05). Conclusions    teady state plasma concentration of sodium valproate can be lowered by meropenem; combined use of sodium valproate and meropenem should be avoided in clinical practice.

  【Key words】Meropenem；Sodium valproate；Plasma-drug concentration