两性霉素B持续鞘内给药治疗新型隐球菌性脑膜炎时在脑脊液中的药代动力学
[Pharmacokinetics of amphotericin B in the cerebrospinal fluid during continuous intrathecal administration for treatment of cryptococcal neoformans meningitis].
作者信息
Fang Min, Lv Tian-ming, Yan Yuan, Liu Shi-ting, Gao Wen-hui, Liu Xiao-jia, Yin Jia, Wang Li, Wang Yuan-yuan
机构信息
Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
出版信息
Nan Fang Yi Ke Da Xue Xue Bao. 2011 Nov;31(11):1929-31.
OBJECTIVE
To explore the pharmacokinetics of amphotericin B (AMB) in the cerebrospinal fluid (CSF) during continuous intrathecal administration of AMB for treatment of cryptococcal neoformans meningitis (CNM).
METHODS
The concentration of AMB in the CSF was measured using reversed phase high performance liquid chromatography (RP-HPLC) in 3 patients receiving continuous intrathecal infusion of AMB for CNM.
RESULTS
AMB concentrations in the CSF of the 3 patients exceeded the minimal inhibitory concentration (MIC) of AMB against Cryptococcus neoformans. The concentration-time curve showed that AMB concentration in the CSF underwent obvious variations on the first day of intrathecal infusion and after additional AMB doses, but maintained a stable level (0.61-1.21 µg/ml) on the next day.
CONCLUSION
[corrected] Continuous intrathecal administration of AMB can enhance the drug concentration in the CSF and maintain a stable and effective drug level for treatment of CNM.
目的
探讨两性霉素B（AMB）持续鞘内给药治疗新型隐球菌性脑膜炎（CNM）时在脑脊液（CSF）中的药代动力学。
方法
采用反相高效液相色谱法（RP-HPLC）测定3例接受AMB持续鞘内输注治疗CNM患者脑脊液中AMB的浓度。
结果
3例患者脑脊液中AMB浓度均超过AMB对新型隐球菌的最低抑菌浓度（MIC）。浓度-时间曲线显示，鞘内输注首日及追加AMB剂量后，脑脊液中AMB浓度有明显变化，但次日维持在稳定水平（0.61-1.21μg/ml）。
结论
持续鞘内给予AMB可提高脑脊液中的药物浓度，并维持稳定有效的药物水平以治疗CNM。
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