Sakurai M, Shibuya S, Miyagishima J, Wakamatsu E
Jpn J Antibiot. 1986 Mar;39(3):739-45.
Cefotaxime (CTX) was intravenously administered in an amount of 2.0 g to each of 34 adult patients before the surgery mainly of the hip joint. Samples of the blood from the bone marrow around the trochanter were taken at the time of the operation. At the same time blood samples were taken from peripheral veins. The sample was centrifuged and the supernatant was analyzed for CTX and desacetyl-CTX. The concentration of CTX in the marrow blood was 150.9 micrograms/ml and that in the blood was 182.5 micrograms/ml in the earliest samples taken at 20 minutes after injection. In the 44 pairs of samples, the concentration of CTX in the marrow blood was lower than that in the peripheral blood in all the cases except 4. The concentration of desacetyl-CTX (Des-CTX), however, in the marrow blood was higher than in the peripheral blood in 33 of the 44 pairs of specimens. Since the degradation of the drug progresses with time, the ratio of Des-CTX to CTX increased with time. This trend was particularly marked in the bone marrow blood and can be expressed as Y = 113.0 + 0.32 t, when Y is the ratio percentage (Des-CTX/CTX) and t is time after the injection of the drug in minute. Thus, CTX transferred into the bone marrow tends to remain there and transformed into the desacetyl form.
对34例主要接受髋关节手术的成年患者,术前静脉注射头孢噻肟(CTX),剂量为每人2.0g。手术时采集转子周围骨髓血样本。同时从外周静脉采集血样。将样本离心,对上清液进行CTX和去乙酰头孢噻肟(desacetyl-CTX)分析。注射后20分钟采集的最早样本中,骨髓血中CTX浓度为150.9微克/毫升,外周血中为182.5微克/毫升。在44对样本中,除4对外,所有病例骨髓血中CTX浓度均低于外周血。然而,在44对样本中的33对中,骨髓血中去乙酰头孢噻肟(Des-CTX)的浓度高于外周血。由于药物降解随时间进展,Des-CTX与CTX的比值随时间增加。这种趋势在骨髓血中尤为明显,当Y为比值百分比(Des-CTX/CTX)且t为注射药物后的时间(分钟)时,可表示为Y = 113.0 + 0.32t。因此,转入骨髓的CTX倾向于留在那里并转化为去乙酰形式。