抗菌药物静脉给药对血浆氧化三甲胺水平的影响OACSTPCD
Effect of Intravenous Administration of Antibiotics on the Level of Plasma Trimethylamine N-Oxide
目的 探讨抗菌药物静脉给药对血浆氧化三甲胺(TMAO)水平的影响.方法 选取湘南学院附属医院 2020 年 10 月至 2021 年8 月收治的合并感染性疾病且静脉使用抗菌药物超过 7d的患者 228 例(男 130 例,女 98 例),采用超高效液相色谱串联质谱法检测抗菌药物治疗前后患者的血浆TMAO水平.分析性别、年龄、抗菌药物种类及用药时长、合并心血管疾病(CVD)对TMAO水平的影响,以及感染性指标(C反应蛋白、白细胞计数、中性粒细胞占比、红细胞沉降率、降钙素原)与TMAO水平的相关性.结果 与抗菌药物使用前比较,患者使用 7d 时的血浆 TMAO 水平显著降低(P<0.01),血浆 TMAO 水平单用 β-内酰胺类药物后显著降低(P<0.01),单用喹诺酮类药物后无显著变化(P>0.05);TMAO水平在不同性别患者间无显著差异(P>0.05),且随着年龄的增长总体呈升高趋势;与使用 1～7 d及 8～14 d比较,使用 15～21 d的血浆TMAO水平显著降低(P<0.01);合用与未合用益生菌患者的血浆TMAO水平无显著差异(P>0.05);合并CVD患者的血浆TMAO水平较未合并患者显著升高(P<0.01).各感染性指标检测值与TMAO水平均无显著相关性(P>0.05).结论 静脉给予抗菌药物能显著降低感染性疾病患者的血浆TMAO水平,且降低程度可能与用药时长及是否合并CVD有关.
Objective To investigate the effect of intravenous administration of antibiotics on the level of plasma trimethylamine N-oxide(TMAO).Methods A total of 228 patients(130 males and 98 females)with infectious diseases receiving intravenous administration of antibiotics more than 7 d in the Affiliated Hospital of Xiangnan University from October 2020 to August 2021 were selected.Ultra-high-performance liquid chromatography-tandem mass spectrometry was used to detect the plasma TMAO level in patients before and after antibiotic treatment.The effects of gender,age,antibiotic types,duration of medication,cardiovascular disease(CVD)on the TMAO level were analyzed,as well as the correlation of infectious indicators[C-reactive protein(CRP),white blood cell count(WBC),neutrophil percentage(NEUT%),erythrocyte sedimentation rate(ESR),procalcitonin(PCT)]with TMAO level.Results Compared with that before the use of antibiotics,the plasma TMAO level of patients significantly decreased after 7 d of use(P<0.01);the plasma TMAO level significantly decreased after single use of β-lactams(P<0.01),while that was similar after single use of quinolones(P>0.05).The TMAO level of male patients was similar with that of female patients(P>0.05),but showed an overall increasing trend with the age.Compared with that after use of antibiotics for 1-7 d and 8-14 d,the plasma TMAO level in patients significantly decreased after use for 15-21 d(P<0.01).There was no significant difference in plasma TMAO level between patients treated with antibiotics combined with probiotics and antibiotics alone(P>0.05).The plasma TMAO level in patients with infectious diseases and CVD was significantly higher than that in patients with infectious diseases alone(P<0.01).There was no significant correlation of various infectious indicators with TMAO level(P>0.05).Conclusion Intravenous administration of antibiotics can significantly decrease the plasma TMAO level in patients with infectious diseases,and the decrease degree may be related to the duration of medication and whether infectious diseases complicated with CVD.
王时云;陈露露;方青;李超;欧阳冬生;李晓晖;舒海媚;罗春阳
湘南学院附属医院,湖南 郴州 423000湘南学院附属医院,湖南 郴州 423000||复杂基质样本生物分析湖南省重点实验室,湖南 长沙 410000复杂基质样本生物分析湖南省重点实验室,湖南 长沙 410000复杂基质样本生物分析湖南省重点实验室,湖南 长沙 410000||中南大学湘雅医院临床药理研究所,湖南 长沙 410000复杂基质样本生物分析湖南省重点实验室,湖南 长沙 410000||中南大学湘雅药学院,湖南 长沙 410000湘南学院药学院,湖南 郴州 423000
药学
氧化三甲胺抗菌药物静脉给药血药浓度用药时长心血管疾病
trimethylamine N-oxideantibioticsintravenous administrationplasma concentrationduration of medicationcardiovascular disease
《中国药业》 2024 (002)
32-36 / 5
湖南省自然科学基金[2022JJ80100];湖南省科技创新计划项目[2018SK52008,2017TP1037];湖南省卫生健康委科研计划项目[B202313018451].
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