2019 年第 5 期 第 14 卷

结合群体药代动力学方法评价拉氧头孢在新生儿感染中的临床应用效果

Clinical evaluation of latamoxef in neonatal infection using population pharmacokinetics

作者：寇晨韩冬李兆娜刘尊杰张亚南高正平

英文作者：

单位：100026首都医科大学附属北京妇产医院新生儿重症监护室

英文单位：

关键词：新生儿感染；拉氧头孢；群体药代动力学

英文关键词：

• 摘要：

• 【摘要】目的    探讨拉氧头孢在当前剂量下对新生儿感染性疾病的治疗效果。方法    选取2016年1月至2017年1月首都医科大学附属北京妇产医院住院应用拉氧头孢钠治疗的84例感染性疾病新生儿，分为足月儿组（38例）和早产儿组（46例）。均采用拉氧头孢30 mg/kg，间隔12 h静脉注射，拟定疗程均为7～14 d。分析治疗过程期间患儿临床资料、辅助检查及治疗效果，结合群体药代动力学对该药物的临床应用进行评价。结果    拉氧头孢在本组患儿中的药物半衰期约为2.95 h。足月儿组应用拉氧头孢白细胞计数水平较治疗前明显下降［（12±6）×109/L比（18±8）×109/L］（P＝0.011），早产儿组治疗后白细胞计数与治疗前比较差异无统计学意义［（11±4）×109/L比（11±4）×109/L］（P＝0.396）。2组患儿C反应蛋白治疗第5天后均较治疗第1天明显降低［足月儿组：（1.3±0.6）mg/L比（15.1±13.2）mg/L，早产儿组：（1.7±1.0）mg/L比（18.4±15.6）mg/L］（均P＜0.001），且均降至正常(＜10 mg/L)。治疗期间，所有患儿均未见皮疹、腹泻、肝肾功能损伤等情况，尤其未见明显出血倾向发生。结论    目前临床应用拉氧头孢(30 mg/kg，间隔12 h静脉注射)的药物半衰期为2.95 h，针对敏感细菌有效，足月儿与早产儿对拉氧头孢的治疗均有效，且未见明显不良反应发生。

• 【Abstract】Objective    To explore the therapeutic effect of latamoxef on neonatal infection using population pharmacokinetics. Methods    Eighty-four cases of neonatal infectious diseases treated with latamoxef in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2016 to January 2017 were enrolled; 38 cases were full-term and 46 cases were premature. Latamoxef 30 mg/kg was intravenously administered at intervals of 12 h; the course of treatment was 7-14 d. Clinical data， auxiliary examinations and therapeutic effect were analyzed. Efficacy of latamoxef was evaluated using population pharmacokinetic method. Results    The half life of latamoxef was approximately 2.95 h. Leukocyte count after medication significantly decreased compared to that before treatment in full-term infants［（12±6）×109/L vs （18±8）×109/L］（P＝0.011） but showed no significant changes in premature babies［（11±4）×109/L vs （11±4）×109/L］（P＝0.396）. Blood level of C-reactive protein dropped to normal(＜10 mg/L) on the 5th day and it was significantly lower than that 1 d after treatment［full-term infants: （1.3±0.6）mg/L vs （15.1±13.2）mg/L; preterm infants: （1.7±1.0）mg/L vs （18.4±15.6）mg/L］（both P＜0.001）. There was no skin rash, diarrhea, liver and kidney function damage during treatment. No obvious bleeding was observed. Conclusion    Clinical application of latamoxef 30 mg/kg every 12 h is effective in both full-term and preterm infants suffering from infection caused by sensitive bacteria; the half life of latamoxef is 2.95 h; no obvious adverse reactions is noticed.