目的:了解我院抗菌药物应用及细菌耐药情况.方法:调取我院2008-2010年抗菌药物的出库数据,采用限定日剂量法分析抗菌药物应用情况；利用我院检验科2009-2010年细菌耐药监测数据,分析临床分离菌对抗菌药物耐药率.结果:头孢菌素尤其是第3代头孢菌素类应用最为频繁；同期临床分离菌以大肠埃希菌、肺炎克雷伯菌与葡萄球菌为主；葡萄球菌对青霉素几乎完全耐药,耐甲氧西林葡萄球菌检出比率较高,尚未见对万古霉素耐药的金黄色葡萄球菌；大肠埃希菌与肺炎克雷伯菌对第3代头孢菌素已显示出较高的耐药率,但对碳青霉烯类、含β-内酰胺酶抑制剂复方制剂(除氨苄西林/舒巴坦)、头霉素类与阿米卡星等均仍敏感.结论:第3代头孢菌素有滥用倾向；临床分离菌以大肠埃希菌、肺炎克雷伯菌与葡萄球菌为主,细菌耐药情况比较严重,须引起重视.%OBJECTIVE: To develop a method for simultaneous determination of 4 lysophosphatidic acids (LPA) in human saliva. METHODS: LC-MS method was adopted. The saliva samples were extracted by HCl-acidified 1-butanol using LPA 17:0 as internal standard. The separation was achieved on Nucleodur 100-5 C8 column with mobile phase composed of methanol-2.5 mmol·L-1 ammonium formate buffer(Ph adjusted to 3.0 using formic acid) (85:15) at a flow rate of 0.5 Ml-muT1. The mass transition of mlz 409.0→153.0, 437.0→153.0, 435.0→153.0, 457.0→153.0, and 423.0→-153.0 were used to detect LPA 16=0,18:0,18:1,20:4,17:0, respectively. RESULTS: The linear range of all LPAs was 5~2 000 μg · L-1. Mean extraction recoveries were in the range of 79.91%~90.01%. The mean method recoveries were in the range of 92.16%~106.37%. RSDs of intra-day and inter-day conwere lower than 15%. CONCLUSION: The method is sensitive, simple and rapid, and it is suitable for the determination of LPAs concentration in human saliva.
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