血浆中阿米卡星的系列谷浓度和峰浓度作为肾毒性预测指标。
Serial trough and peak amikacin levels in plasma as predictors of nephrotoxicity.
作者信息
Contreras A M, Gamba G, Cortés J, Santiago Y, Nares F, Jimenez-Sanchez G, Bobadilla J, López G, Valadez A, Espinosa A
机构信息
Department of Nephrology, Instituto Nacional de la Nutrición Salvador Zubirán, Mexico, D.F.
出版信息
Antimicrob Agents Chemother. 1989 Jun;33(6):973-6. doi: 10.1128/AAC.33.6.973.
We studied 113 patients treated with intravenous amikacin to determine the value of determining serial trough and peak amikacin levels in plasma for predicting nephrotoxicity. Thirteen patients (11.5%) developed renal toxicity, with significant increases from 48 to 96 h in both peak and trough amikacin levels (6.7 +/- 4.7 [standard deviation] days before the serum creatinine rose). The nontoxicity group had no change or even showed decrements in amikacin levels in plasma. A higher nephrotoxicity risk was seen in patients with increments greater than 1 microgram/ml between 48 and 96 h, with odds ratios of 16.4 for trough, 8 for peak, and 7.2 for both levels. We suggest that an increment of at least 1 microgram/ml in amikacin levels in plasma from 48 to 96 h may predict the appearance of renal toxicity.
我们研究了113例接受静脉注射阿米卡星治疗的患者，以确定测定血浆中阿米卡星系列谷值和峰值水平对预测肾毒性的价值。13例患者（11.5%）出现肾毒性，在血清肌酐升高前，阿米卡星的峰值和谷值水平在48至96小时内显著升高（6.7±4.7[标准差]天）。无毒组血浆中阿米卡星水平无变化甚至下降。在48至96小时内增量大于1微克/毫升的患者中，肾毒性风险更高，谷值的优势比为16.4，峰值为8，两者均为7.2。我们认为，血浆中阿米卡星水平在48至96小时内至少增加1微克/毫升可能预示肾毒性的出现。
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