中国新生儿万古霉素血药浓度监测回顾性分析  

Retrospective Analysis of Serum Concentration Monitoring of Vancomycin in Neonates in China

作　　者：郭义明[1] 郭鑫[1] 白凤芝[1] Guo Yiming;Guo Xin;Bai Fengzhi(China-Japan Union Hospital of Jilin University,Jilin Changchun 130033,China)

机构地区：[1]吉林大学中日联谊医院

出　　处：《儿科药学杂志》2020年第1期39-42,共4页Journal of Pediatric Pharmacy

摘　　要：目的:分析中国新生儿万古霉素治疗药物浓度监测(TDM)现状,为临床用药提供建议。方法:检索中文数据库中国知网、万方数据、维普网,检索时限为建库至2017年12月31日,纳入新生儿万古霉素TDM文献,统计监测例次、监测依据、监测方法、给药方案、首次采血时间、谷浓度范围、不良反应。结果:纳入14篇文献,1273例新生儿的万古霉素TDM 1968例次。多数文献明确了以指南或专家共识作为监测依据,测定方法以高效液相色谱法为主(71.80%),92.38%的TDM采用了说明书的给药方案,73.68%的TDM采用4~5个维持剂量采血;21.24%的TDM谷浓度平均值在10~20 mg/L之间,78.76%的TDM谷浓度平均值<10 mg/L,不良反应发生率为15.24%。结论:中国新生儿万古霉素TDM数量较少,且60%以上的谷浓度监测结果不在治疗范围内,加强TDM十分必要。Objective:To analyze the current status of therapeutic drug monitoring(TDM)of vancomycin in neonates in China,and to provide recommendations for clinical drug use.Methods:CNKI,Wanfang database,VIP were retrieved,the retrieve time was from the establishment of the database to Dec.31 st,2017.Monitoring cases,monitoring basis,monitoring method,drug administration regimen,collection time of first blood,valley concentration range and adverse drug reactions were statistically analyzed.Results:A total of 14 literature were collected,including 1,273 neonates with 1,968 cases of TDM of vancomycin.Most of the literature had been clear about the guide or expert consensus as monitoring.The determination method was mainly high performance liquid chromatography(71.80%).Totally 92.38% of TDM used the dosing regimen from the instructions,73.68% of TDM used 4 to 5 maintenance doses for blood collection.And 21.24% of TDM with average valley concentration ranged from 10 to 20 mg/L,78.76%of TDM with average valley concentration<10 mg/L.The incidence of adverse drug reactions was 15.24%.Conclusion:The number of TDM of vancomycin in neonates in China is relatively small,and the monitoring results of valley concentration above 60% are not within the scope of treatment,it is necessary to strengthen the TDM.

关 键 词：万古霉素 血药浓度监测 谷浓度 新生儿 

分 类 号：R969.3[医药卫生—药理学]