万古霉素对MRSA感染的呼吸机相关性肺炎患者肾功能的影响  

Effect of Vancomycin on Renal Function in the Ventilator-associated Pneumonia Patients

作　　者：刘艳萍[1] 董伟[1] 段崇浩[2] 刘丽[1] 杨逢永[2] 亓永杰[2] 

机构地区：[1]泰山医学院附属莱芜市人民医院药剂科,山东省莱芜市271199 [2]泰山医学院附属莱芜市人民医院重症医学科,山东省莱芜市271199

出　　处：《医学理论与实践》2016年第10期1266-1267,1273,共3页The Journal of Medical Theory and Practice

基　　金：莱芜市科技局2012年科研立项项目(2012030103)

摘　　要：目的:观察呼吸机相关性肺炎患者使用万古霉素治疗时肾功能变化情况。方法:32例耐甲氧西林金黄色葡萄球菌(MRSA)感染的呼吸机相关性肺炎患者,给予万古霉素治疗,动态监测肾功能变化,利用高效液相色谱法进行万古霉素谷浓度、峰浓度测定。根据有无出现肾毒性分为肾功能正常组(A组)、肾毒性组(B组),比较两组患者在年龄、APACHEⅡ评分、临床疗效及万古霉素血药浓度方面的差异。结果:15例(46.88%)患者出现肾损害,两组年龄、临床有效率、万古霉素谷浓度、峰浓度比较无统计学意义,A组APACHEⅡ评分低于B组。结论:危重患者使用万古霉素治疗时发生肾毒性的风险偏高,临床中应进行个体化调整剂量治疗。Objective：To discuss the influence of Vancomycin to the renal function in the ventilator-associated pneumonia patients.Methods：32cases of VAP patients infected with MRSA accepted Vancomycin therapy.The dynamic changes of renal function were observed,trough concentration and peak concentration were determined by high performance liquid chromatography.According to the renal function patients were assigned to two groups：the normal renal function group（group A）and the renal toxicity group（group B）.The age,APACHEⅡ score,clinical effect and blood concentration of Vancomycin were compared between the two groups.Results：The renal function of 15patients（46.88%）was impaired,there was no statistically significant difference between the two groups in the age,clinical effect and blood concentration of Vancomycin.the APACHEⅡ score of group A was significantly lower than group B.Conclusion：The risk of renal toxicity in critically ill patients treated with Vancomycin is high.It is advised to adjust the dosage for individualized treatment.

关 键 词：万古霉素 呼吸机相关性肺炎 肾毒性 

分 类 号：R563.1[医药卫生—呼吸系统]