用SAS迭代及蒙特卡罗模拟优化美罗培南的使用

中国临床药理学与治疗学 ›› 2012, Vol. 17 ›› Issue (5): 529-535.

用SAS迭代及蒙特卡罗模拟优化美罗培南的使用

沈惠峰¹, 张睢扬², 常艳², 任娟²

¹苏州大学,苏州 215006,江苏;
²中国人民解放军第二炮兵总医院呼吸及重症医学科,北京 100086

收稿日期:2012-01-13 修回日期:2012-04-15 出版日期:2012-05-26 发布日期:2012-05-28
通讯作者: 张睢扬,男,教授,研究方向:呼吸及重症研究。Tel: 13693652527 E-mail: suiyangzhang@yahoo.com
作者简介:沈惠峰,男,硕士研究生在读,医师,研究方向:肺部感染的基础与临床研究。Tel: 15810132077 E-mail: 997759171@qq.com

Use of SAS iteration and Monte Carlo simulation to optimize use of Meropenem

SHEN Hui-feng¹, ZHANG Sui-yang², CHANG Yan², REN Juan²

¹Soochow University, Suzhou 215006, Jiangsu,China;
²Department of Respiratory and Instensive Care Unit, the General Hospital of Second Artillery Force of the PLA, Beijing 100086,China

Received:2012-01-13 Revised:2012-04-15 Online:2012-05-26 Published:2012-05-28

摘要/Abstract

摘要： 目的:筛选出针对临床上不同MIC值细菌时美罗培南的最优的药物剂量和点滴方式,同时比较传统、延长及优化两步点滴法的药效学。方法: 首先用SAS迭代的方法筛选出在不同的MIC值时美罗培南两步点滴法时最优的药物剂量和点滴方式,然后使用蒙特卡罗模拟计算传统、延长及优化两步点滴法时的%T>MIC的值和达标概率。结果: 在SAS迭代时,MIC为1、2、4 μg/mL 及CL和V_d取均数时,分别按 500 mg,0.25 h/100 mg+2.75 h/400 mg;500 mg,0.25 h/250 mg+2.75 h/250 mg 和 1000 mg;0.25 h/400 mg+2.75 h/600 mg 的优化两步点滴法的模型最优。在不同的MIC时,蒙特卡罗模拟均显示出在延长点滴和优化两步点滴法比传统点滴法有更高的%T>MIC和达标概率,优化两步点滴法比延长点滴法的达峰时间更短。结论:SAS迭代可以用来筛选出最优的药物剂量和点滴方式,同时蒙特卡罗模拟可以用来比较不同点滴方式的药效学。结果显示优化两步点滴法是更好的治疗临床严重感染的方法。

关键词: 迭代, 蒙特卡罗模拟, 美罗培南, 优化两步点滴法

Abstract: AIM: To choose optimized dosages and regimens of Meropenem based on different MICs of clinical organisms, meanwhile to evaluate pharmacodynamics of traditional(TIT),prolonged(PIT) and optimized two-step infusion therapy(OTIT) of Meropenem.METHODS: Firstly, use ofSAS iteration to choose optimized dosages and regimens of Meropenem based on different MICs of clinical organisms in the condition of two-step infusion therapy;secondly,use of Monte Carlo Simulation to calculate the %T>MIC and the probability of target attainments(PTAs) of TIT,PIT and OTIT, respectively.RESULTS:Based on the MICs of 1,2,4 μg/mL and means of CL and V_d, the dosing regimens of OTIT with 500 mg, 0.25 h/100 mg+2.75 h/400 mg; 500 mg, 0.25 h/250 mg+2.75 h/250 mg and 1000 mg, 0.25 h/400 mg+2.75 h/600 mg provided the highest %T>MIC with SAS iteration, respectively. Monte Carlo Simulation revealed that PIT and OTIT obtained higher %T>MIC and PTAs compared with TIT at different MICs,Meanwhile OTIT obtained shorter the time to maximum concentration(t_max) compared with PIT.CONCLUSION: SAS iteration may be performed to choose the best optimized dosages and regimens of antibiotics. Monte Carlo simulation may be performed to compare pharmacodynamic parameters of different dosing regimens.These results suggested that OTIT was better therapy against clinically serious infections.

Key words: Iteration, Monte Carlo simulation, Meropenem, Optimized Two-step infusion therapy

中图分类号:

R978.1

沈惠峰, 张睢扬, 常艳, 任娟. 用SAS迭代及蒙特卡罗模拟优化美罗培南的使用[J]. 中国临床药理学与治疗学, 2012, 17(5): 529-535.

SHEN Hui-feng, ZHANG Sui-yang, CHANG Yan, REN Juan. Use of SAS iteration and Monte Carlo simulation to optimize use of Meropenem[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2012, 17(5): 529-535.

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