万古霉素血药浓度监测及儿童用药评价  

Monitoring of serum vancomycin concentration and evaluation of children's medication

作　　者：周敬凯 张媞[1] 邹佳运 李爽[1] 孙浩[1] 肇丽梅[1] 陈愉[1] 

机构地区：[1]中国医科大学附属盛京医院药学部,沈阳110004 [2]大连医科大学基础医学院,2010级大连116000

出　　处：《实用药物与临床》2014年第10期1306-1309,共4页Practical Pharmacy and Clinical Remedies

基　　金：辽宁省自然科学基金(2013021079)

摘　　要：目的分析ICU患者和PICU患者万古霉素的血药浓度,以成人血药浓度为基准,为儿童患者的剂量选择提供参考。方法测定2012年11月至2013年4月于我院PICU病房治疗的49例重症感染患儿使用万古霉素后的血药浓度值,以及2010年9月至2012年11月于我院ICU病房治疗的68例重症感染患者使用万古霉素后的血药浓度值。将浓度值、年龄、肝肾功指标等资料录入数据库,进行统计学分析。结果成人患者和儿童患者万古霉素谷浓度有显著性差异（P=0.00）。进一步分析显示,成人患者中,当万古霉素谷浓度为15-20μg/mL时,其疗效最好（P=0.03）;儿童患者中,当万古霉素谷浓度为10-15μg/mL时,其疗效最好（P=0.00）。结论以成人血药浓度为基准,儿童万古霉素给药剂量偏低,血药浓度偏低,应给予足量万古霉素,以使其血药浓度尽快达到有效抑菌浓度。Objective To analyze the plasma concentration of vancomycin in PICU and ICU patients,and make a reference dose selection for the pediatric patients using plasma concentration of vancomycin in adults as benchmark. Methods The plasma concentration of vancomycin in 49 children with severe infection in PICU of our hospital from November 2012 to April 2013 and the plasma concentration of vancomycin in 68 adult patients with severe infection in ICU of our hospital from September 2010 to November 2012 were measured. The concentration,age,liver and kidney function indicators and other information were entered into the database,and the statistical analysis was used.Results The trough concentrations of adult patients and pediatric patients were different（P = 0. 00）. Further analysis showed that,the effect of vancomycin was best in adult patients when the trough concentrations was 15 -20 μg /mL（P =0.03）,the effect of vancomycin was best in pediatric patients when the trough concentrations was 10 ~15 μg/mL（P =0.00）. Conclusion The dose and plasma concentration of vancomycin in children is low,using the plasma concentration in adults patients as basis. Adequate dose of vancomycin should be given to achieve the effective inhibitory concentration quickly.

关 键 词：万古霉素 血药浓度 谷浓度 儿童 成人 

分 类 号：R96[医药卫生—药理学]