替考拉宁首次负荷剂量对造血系统恶性肿瘤合并感染患者临床疗效影响  

Effect of the First Loading Dosage of Teicoplanin on the Clinical Efficacy of Patients with Hematopoietic Malignancies Co-infection

作　　者：邱瑾 袁凯锋 韩丽英 Qiu Jin;Yuan Kaifeng;Han Liying(Department of Hematology,Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China)

机构地区：[1]西南医科大学附属医院血液内科,四川泸州646000

出　　处：《四川医学》2020年第2期174-178,共5页Sichuan Medical Journal

摘　　要：目的探讨替考拉宁不同初始负荷剂量对造血系统恶性肿瘤合并感染患者的临床疗效影响。方法回顾性分析我院50例使用替考拉宁造血系统恶性肿瘤合并感染患者临床疗效,通过监测替考拉宁初始常规和优化负荷剂量造血系统恶性肿瘤患者第6剂用药前30min血药浓度(稳态谷浓度),比较两组患者替考拉宁血药谷浓度、治疗效果、超敏C反应蛋白(hs-CRP)和降钙素原(PCT)变化以及不良反应,评价临床疗效及安全性。结果优化组平均稳态谷浓度明显高于常规组[(15.82±3.16)mg/L vs.(10.77±4.10)mg/L,P<0.05];优化组治疗有效率明显高于常规组(80.0%vs.48.0%,P<0.05);优化组患者hs-CRP和PCT水平较常规组患者明显下降(P<0.05);优化组与常规组不良反应率相当(4.0%vs.12.0%,P>0.05)。结论对于造血系统恶性肿瘤合并感染患者,提高替考拉宁初始负荷剂量可以达到较高的有效血药谷浓度,临床疗效更好,且不良反应未见增加。Objective To investigate the clinical application of teicoplanin plasma concentration in patients with hematological malignancies co-infection,and to provide a basis for clinical selection of the initial dosage of teicoplanin.Methods Recalling patients with hematologic malignancies co-infection who were treated with teicoplanin and monitored for trough concentration at 30 minutes before the 6th dosage(trough concentration).The trough concentration,treatment effect,hs-CRP and PCT changes and adverse reactions were compared between the two doses patients to evaluate the clinical efficacy and safety.Results The average steady-state trough concentration and treatment efficiency of the optimized group were significantly higher than those of the conventional group.The hs-CRP and PCT levels of the optimized group were significantly lower;the optimized group did not increase the adverse reaction rate.Conclusion For patients with hematologic malignancies co-infection,increasing the initial loading dosage of teicoplanin can achieve a higher effective trough concentration,and the clinical efficacy is exact,safe and reliable.

关 键 词：替考拉宁 血药浓度 造血系统恶性肿瘤 感染 合并症 

分 类 号：R733.7[医药卫生—肿瘤]