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目的:研究氨溴索对肺部耐甲氧西林金黄色葡萄球菌(MRSA)感染患者血液与肺部万古霉素浓度的影响,评价两药联用的合理性。方法:44例肺部MRSA感染患者经纳入后随机分为2组:A组患者入组后即给万古霉素1.0g,ivd,q12h。B组患者入组后即给药万古霉素1.0g,ivd,q12h,联合使用氨溴索60 mg,iv,q12h。于第4个万古霉素给药剂量之前以咳痰或负压吸痰采集痰液样本,同时收集患者血清。采用荧光偏振免疫法(FPIA法)测定万古霉素浓度。结果:A组、B组患者痰液中万古霉素质量浓度分别为(1.8±2.1)μg.mL-1,(3.6±3.1)μg.mL-1,2组差异有显著性(P<0.05);A组、B组患者万古霉素血药质量浓度分为(15.7±2.5)μg.mL-1,(14.7±2.8)μg.mL-1,2组差异无显著性(P>0.05)。结论:万古霉素与氨溴索联合使用可增加肺部MRSA感染患者痰液中万古霉素浓度,不影响血液中万古霉素的浓度。
Objective: To study the effect of ambroxol on the concentration of vancomycin in blood and lung in patients with MRSA infection in lung and to evaluate the rationality of combination of two drugs. Methods: Forty-four patients with pulmonary MRSA infection were randomly divided into two groups: Group A received vancomycin 1.0 g, ivd, and q12 h after the intervention. Group B patients were administered vancomycin 1.0g, ivd, q12h, combined ambroxol 60 mg, iv, q12h. Sputum samples were taken either sputum or negative pressure before the fourth dose of vancomycin, and patient sera were collected. Vancomycin concentrations were determined by fluorescence polarization immunoassay (FPIA method). Results: The concentrations of vancomycin in sputum of patients in group A and group B were (1.8 ± 2.1) μg.mL-1 and (3.6 ± 3.1) μg.mL-1 and 2, respectively ). The plasma concentrations of vancomycin in patients in group A and group B were (15.7 ± 2.5) μg.mL-1 and (14.7 ± 2.8) μg.mL-1 and no significant difference (P> 0.05) . Conclusion: The combination of vancomycin and ambroxol increases the concentration of vancomycin in the sputum of MRSA-infected patients without affecting the concentration of vancomycin in the blood.