100例监测万古霉素血药浓度住院患者的用药分析  

Analysis of Medication in 100 Cases Hospitalized Patients with Determination of Vancomycin Plasma Concentration

作　　者：孙秀漫[1] 杨佳彬[1] 姜顺军[2] 曾彩芳[1] 

机构地区：[1]广州医科大学附属第二医院,广东广州511447 [2]广州医科大学附属第一医院,广东广州510120

出　　处：《今日药学》2018年第1期47-49,共3页Pharmacy Today

基　　金：广东省医院药学研究基金(2017A10)

摘　　要：目的前期研究发现合并用药可能干扰万古霉素血药浓度的监测结果,拟分析2016年3~4月某院100例监测万古霉素血药浓度住院患者的用药情况,为合并用药种数多的患者监测万古霉素血药浓度的方法提供数据基础。方法采用回顾性分析方法,收集某院经静脉注射使用万古霉素并进行常规TDM的100例成年患者的资料,包括年龄、性别、科室、血肌酐、血药浓度与用药医嘱(用药种类与数量),并进行统计分析。结果 100例成年患者中,男71例,女29例,平均年龄(59.06±14.83)岁,主要分布在呼吸内科、重症医学科、胸外科。100例患者的血肌酐异常值发生率为15%,其中血药浓度大于20μg·mL^(-1)的异常值发生率是35.7%,是血药浓度在10~20μg·mL^(-1)(10.5%)的3倍;用药品种数在10种以上者占66%,常合并使用的15种药物多为慢性病常用药。结论 100例患者的平均年龄较大,且合用药种数多。万古霉素的肾毒性不良反应与体内血药浓度密切相关,准确监测其血药浓度尤为重要。OBJECTIVE Preliminary study findings co-administration of drugs may interfere with the results of the accurate determination of vancomycin in previous studies,this study aim to collect the data on drugs often used together with vancomycin,by way of studying 100 cases of using vancomycin in one hospital from March to April of 2016 for further analysis. METHODS Retrospective analysis was conducted on the information of the 100 patients who intravenously used vancomycin and had been monitored drug concentration in blood,including ages,gender,department,serum creatinine,blood concentration and drug categories and does medically indicated. RESULTS The100 patients,including 71 case male and 29 case female with the average ages of（59. 06 ± 14. 83）,were mainly distributed in respiratory medicine,ICU and thoracic surgery. 15% of the patients were with serum creatinine in the abnormal range. And the abnormal rate of the plasma concentration greater than 20 μg·mL^-1 was 35.7%,which was 3 times of the abnormal rate of the plasma concentration at 10-20 μg·mL^-1. 66% of patients took drugs of more than 10 kinds. And the drugs were mostly commonly used to treat chronic diseases. CONCLUSION The average age of the 100 patients is higher,and the kinds of drugs patients taking is more. Renal toxicity of vancomycin is closely related to its blood concentration,it is particularly important to monitor the blood concentration accurately.

关 键 词：万古霉素 用药分析 血药浓度监测 

分 类 号：R969.4[医药卫生—药理学]