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目的了解肌注庆大霉素后泪液中药物浓度及其动态变化。方法选择志愿受试者２６例，采用荧光偏振免疫分析法测定了单剂量肌注庆大霉素后血清及不同时间泪液药物浓度。结果１６例非炎症眼受试者肌注庆大霉素１２０ｍｇ后１ｈ泪药浓度达到峰值（０．８７±０．６６ｍｇ／Ｌ），相应的血药浓度峰值为８．０３±１．６１ｍｇ／Ｌ，泪、血药物浓度比值为０．１０８±０．０９９；１０例单眼角膜溃疡组肌注庆大霉素１２０ｍｇ（其中１例１３岁儿童肌注８０ｍｇ）后１ｈ溃疡眼的泪药浓度为１．０６±０．５４ｍｇ／Ｌ，明显高于对侧非炎症眼的０．４４±０．１７ｍｇ／Ｌ（Ｐ＜０．０１）。非炎症眼及角膜溃疡眼泪药浓度均未达到庆大霉素对大多数细菌性角膜溃疡常见致病菌的有效治疗浓度。结论治疗细菌性角膜溃疡时，庆大霉素不宜采用全身给药。
Objective To understand the drug concentration and dynamic changes in tear after intramuscular injection of gentamicin. Methods Twenty-six volunteers were selected. Fluorescence polarization immunoassay was used to determine the concentration of drug in serum and tear fluid after single-dose intramuscular injection of gentamycin. Results In 16 noninflammatory subjects, the tear concentration peaked at 1h after gentamicin 120mg (0.87 ± 0.66mg / L), and the corresponding peak plasma concentration was 8.03 ± 1.61mg / L, tear, blood drug concentration ratio of 0.108 ± 0.099; 10 eyes monocular corneal ulcer group intramuscular injection of gentamicin 120mg (1 case of 13-year-old children with intramuscular injection of 80mg) 1h after ulcer eye tear drug concentration 1.06 ± 0.54mg / L, which was significantly higher than that of contralateral non-inflammatory eyes (0.44 ± 0.17mg / L, P <0.01). Non-inflammatory eye and corneal ulcer tear drug concentration did not reach the effective treatment of gentamicin common bacteria most common bacterial pathogenic bacteria. Conclusion In the treatment of bacterial corneal ulcer, gentamicin should not be administered systemically.