Watterberg K L, Kelly H W, Johnson J D, Aldrich M, Angelus P
Dev Pharmacol Ther. 1987;10(2):107-17. doi: 10.1159/000457735.
The effect of patent ductus arteriosus (PDA) and its therapy on the pharmacokinetic disposition of gentamicin in very low birth weight neonates was studied. Twenty-four neonates weighing less than 1,500 g with PDA were compared to 16 patients without PDA. Patients with PDA had significantly greater apparent volumes of distribution (0.64 +/- 0.20 vs. 0.41 +/- 0.08 l/kg; p less than 0.001) and serum half-life (8.49 +/- 2.69 vs. 6.23 +/- 1.92 h; p less than 0.01). The total body clearance was not significantly different between the two groups (56 +/- 20 ml/kg/h with PDA vs. 50 +/- 24 ml/kg/h without PDA). In addition, 7 patients were studied before and after PDA closure. The apparent volume of distribution fell in every case (p = 0.02). A statistically significant effect on clearance and half-life was not found. These findings suggest that PDA increases extracellular fluid volume, but does not affect glomerular filtration rate adversely. Additionally, serum gentamicin concentrations must be reevaluated after PDA closure in premature neonates.
研究了动脉导管未闭（PDA）及其治疗对极低出生体重儿庆大霉素药代动力学处置的影响。将24例体重小于1500g且患有PDA的新生儿与16例无PDA的患者进行比较。患有PDA的患者的表观分布容积（0.64±0.20对0.41±0.08l/kg；p＜0.001）和血清半衰期（8.49±2.69对6.23±1.92小时；p＜0.01）明显更大。两组之间的总体清除率无显著差异（患有PDA的为56±20ml/kg/h，无PDA的为50±24ml/kg/h）。此外，对7例患者在PDA闭合前后进行了研究。每种情况下表观分布容积均下降（p = 0.02）。未发现对清除率和半衰期有统计学显著影响。这些发现表明，PDA增加细胞外液量，但不会对肾小球滤过率产生不利影响。此外，早产儿PDA闭合后必须重新评估血清庆大霉素浓度。
