Nathorst-Böös J, Philipson A, Hedman A, Arvisson A
Department of Obstetrics and Gynecology, Danderyds Hospital, Karolinska Institutet, Sweden.
Am J Obstet Gynecol. 1995 Jan;172(1 Pt 1):163-6. doi: 10.1016/0002-9378(95)90107-8.
Our purpose was to study the pharmacokinetics of ceftazidime at different stages of pregnancy and in the nonpregnant state to determine whether glomerular filtration rate is altered and whether tubular secretions occurs.
Twelve pregnant women with asymptomatic bacteruria were given a bolus dose of 400 mg of ceftazidime followed by a constant infusion for 4 hours. Inulin was infused simultaneously to determine glomerular filtration rate. Blood samples were drawn every 30 minutes. Urine was collected immediately after the bolus dose and then every hour. The same study procedure was then repeated twice: 2 weeks before the expected delivery and after termination of breast-feeding.
At term clearance values were raised by 50% to 100% compared with the values found in the postpartum period. At all observation points a close correlation between inulin and ceftazidime clearance values were found.
The results strongly indicate that ceftazidime is excreted exclusively by glomerular filtration with no tubular reabsorption. During pregnancy the excretion pattern is unaltered, but renal elimination is increased.
我们的目的是研究头孢他啶在妊娠不同阶段及非妊娠状态下的药代动力学，以确定肾小球滤过率是否改变以及是否发生肾小管分泌。
对12例无症状菌尿的孕妇静脉注射400mg头孢他啶，随后持续输注4小时。同时输注菊粉以测定肾小球滤过率。每30分钟采集一次血样。静脉注射后立即收集尿液，然后每小时收集一次。然后重复相同的研究过程两次：预期分娩前2周和停止母乳喂养后。
足月时的清除率值比产后发现的值提高了50%至100%。在所有观察点，菊粉和头孢他啶清除率值之间都发现了密切的相关性。
结果有力地表明，头孢他啶完全通过肾小球滤过排泄，无肾小管重吸收。在怀孕期间，排泄模式未改变，但肾脏清除增加。
