托布拉米辛在吸入托布拉米辛治疗的肺移植患者的系统吸收:一个队列研究
Abiu Sempere1, Ibai Los-Arcos1, Judith Sacanell2
1Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
概括
在肺移植接受者 (LTR) 中,吸入的托布拉米辛通常会导致可检测的血清水平,特别是在通风患者中. 这种系统吸收与急性损伤 (AKI) 的显著风险有关.
科学领域:
- 药理学和毒理学 药理学和毒理学
- 肺病学和呼吸系统医学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 吸入式托布拉米用于肺移植接受者 (LTR).
- 潜在的毒性和全身吸收是令人担忧的,但数据有限.
- 了解药物水平和损伤风险对于LTR管理至关重要.
研究的目的:
- 在接受吸入治疗的LTR中评估血清托布拉米辛水平.
- 调查可检测/高血清水平与急性损伤 (AKI) 之间的关联.
- 为了确定患者的因素,如机械通风,影响系统吸收.
主要方法:
- 对成年LTR接受吸入托布拉米辛治疗 (≥3天) 的回顾性观察性研究.
- 收集的最低血清托布拉米辛水平;>2μg/mL定义为高.
- 评估AKI作为可检测水平的患者的次要结果.
主要成果:
- 在34名LTR中,82%的患者有可检测的血清托布拉米辛水平;26%的患者有高水平 (>2微克/毫升).
- 26%的患者在治疗期间发生AKI.
- 侵入性机械通风患者的中位数值显著更高 (2.5μg/mL与0.48μg/mL).
结论:
- 吸入的托布拉米辛经常导致LTR的全身吸收.
- 高系统吸收和AKI风险在侵入性通风的LTR中增加.
- 监测血清水平和功能对于接受吸入托布拉米辛的LTR至关重要.
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