血漿標本病毒滅活處理對伏立康唑、利奈唑胺、萬古霉素和替考拉寧血藥濃度檢測的影響

李紅蓮 周瓊 張峻 黃樺 王晶晶 姚勤

中圖分類號 R917 文獻標志碼 A 文章編號 1001-0408（2021）19-2394-06

DOI 10.6039/j.issn.1001-0408.2021.19.15

摘 要 目的：研究血漿標本病毒滅活處理對伏立康唑、利奈唑胺、萬古霉素和替考拉寧血藥濃度檢測的影響。方法：以我院36例住院患者分別行常規伏立康唑、利奈唑胺、萬古霉素和替考拉寧血藥濃度檢查后剩余的血漿為檢測標本（每種藥物的含藥血漿均為9份），根據各藥物的常規血藥濃度檢測結果按3個一組將其分別分為低、中、高3個濃度水平的混合標本;然后將不同濃度水平的混合標本分別分為滅活組和非滅活組，每組3份。滅活組標本采用56 ℃干式恒溫金屬浴加熱30 min進行滅活處理，非滅活組標本不作處理。兩組血漿樣本分別進行前處理后，采用二維液相色譜法分別測定4種藥物的血藥濃度，比較其檢測結果差異。結果：含伏立康唑、利奈唑胺、萬古霉素和替考拉寧的血漿標本經56 ℃干式恒溫金屬浴加熱30 min滅活后依然較穩定;相較于非滅活組，滅活組低、中、高濃度水平混合血漿樣本中上述4種藥物的血藥濃度檢測結果的相對誤差均小于15%。結論：采用二維液相色譜法測定血漿標本中伏立康唑、利奈唑胺、萬古霉素和替考拉寧的血藥濃度時，可采用56 ℃干式恒溫金屬浴加熱30 min的方法對血漿標本進行滅活。

關鍵詞 伏立康唑;利奈唑胺;萬古霉素;替考拉寧;血藥濃度;血漿標本;病毒滅活

Effects of Virus Inactivation Treatment of Plasma Specimen on Plasma Concentration Determination of Voriconazole，Linezolid，Vancomycin and Teicoplanin

LI Honglian，ZHOU Qiong，ZHANG Jun，HUANG Hua，WANG Jingjing，YAO Qin（Dept. of Clinical Pharmacy， the First Affiliated Hospital of Kunming Medical University， Kunming 650000， China）

ABSTRACT ? OBJECTIVE： To study the effects of virus inactivation treatment of plasma specimen on plasma concentration determination of voriconzole，linezolid，vancomycin and teicoplanin. METHODS： The remaining plasma of 36 inpatients in our hospital after routine blood concentration examination of voriconazole， linezolid， vancomycin and teicoplanin were collected as specimen （9 drug-contained plasma specimens for each drug）， and merged into three different concentration levels （low， medium， high） of mixed samples according the results of routine blood test. Then the mixed samples with different concentration levels were divided into inactivated group and non-inactivated group， with 3 samples in each group. The inactivated plasma samples were heated at 56 ℃ for 30 min in metal bath with constant temperature. Non-inactivated group were not treated. After pretreating plasma sample of 2 groups， 2-dimensional liquid chromatography was used to detect plasma concentration of the four drugs; the difference of detection result between inactivated group and non-inactivated group were analyzed. RESULTS： Plasma samples containing voriconazole， linezolid， vancomycin and teicoplanin were still stable after heating at 56 ℃ for 30 min in metal bath with constant temperature. Compared with non-inactivated group， relative error of plasma concentration detection result of above 4 drugs were all lower than 15% in low， medium， high concentration mixed samples of inactivated group. CONCLUSIONS： Plasma samples can be inactivated by heating at 56 ℃ for 30 min in metal bath with constant temperature， when the plasma concentration of voriconazole，linezolid，vancomycin and teicoplanin are determined by 2-dimensional liquid chromatography.