359例非透析患者万古霉素血药浓度监测结果分析  

Analysis of serum concentrations of vancomycin in 359 non-dialysis patients

作　　者：秦英[1] 张达伟 石秀锦[1] 李骁[1] 井浣雨 闫晓昆 林阳[1] QIN Ying;ZHANG Da-wei;SHI Xiu-jin;LI Xiao;JING Huan-yu;YAN Xiao-kun;LIN Yang(Department of Pharmacy,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院药事部,北京100029

出　　处：《中国药物应用与监测》2020年第2期77-80,127,共5页Chinese Journal of Drug Application and Monitoring

基　　金：北京市医院管理局临床医学发展专项“扬帆”计划(ZYLX201805)。

摘　　要：目的:分析万古霉素血药浓度监测数据,为临床合理用药提供参考。方法:抽取2013–2018年我院使用万古霉素并进行血药浓度监测的非透析患者信息,回顾性分析血药浓度达标情况,探讨性别、年龄、体重、肌酐清除率和万古霉素单位体重日剂量对血药浓度的影响。结果:591例次万古霉素血药浓度在10~20 mg·L^-1的占40.27%,首次监测浓度在10~20mg·L^-1的占37.88%,复杂感染和非复杂感染患者血药浓度在10~20 mg·L^-1的分别占33.69%和42.44%。性别、年龄、体重、肌酐清除率和万古霉素单位体重日剂量均影响初始血药浓度,多元线性回归显示性别、肌酐清除率及万古霉素单位体重日剂量与初始血药浓度相关(P<0.05)。结论:我院患者万古霉素血药浓度在10~20 mg·L^-1的构成比低,临床宜结合患者具体情况制定个体化给药方案并及时参考血药浓度结果进行调整。Objective:To analyze results of the therapeutic drug monitoring(TDM)of vancomycin in order to provide references for clinical rational drug use.Methods:The information of non-dialysis patients using vancomycin and undergoing TDM of vancomycin from 2013 to 2018 in our hospital were included.TDM results of vancomycin were retrospectively analyzed.The influence of gender,age,weight,creatinine clearance and vancomycin daily dose by weight on serum concentration of vancomycin was investigated.Results:Among 591 cases,40.27%of cases had serum concentrations of vancomycin in the range of 10 mg·L^-1 to 20 mg·L^-1.The first monitoring result of vancomycin in 37.88%of cases were in the range of 10~20 mg·L^-1.The proportion of serum concentrations of vancomycin in the range of 10~20 mg·L^-1 in patients with complicated infection and non-complicated infection were 33.69%and 42.44%,respectively.The gender,age,weight,creatinine clearance and vancomycin daily dose by weight all had significant influence on the initial serum level of vancomycin.Results of multiple linear regression test showed that creatinine clearance,vancomycin daily dose by weight and gender were significantly correlated with the initial serum level of vancomycin(P<0.05).Conclusion:The percentage of non-dialysis patients having serum concentrations of vancomycin in the range of 10-20 mg·L^-1 in our hospital was relatively low.It was important to make individualized dosing regimen of vancomycin based on the patients’condition and adjust the dosage timely according to the results of TDM.

关 键 词：万古霉素 血药谷浓度 血药浓度监测 影响因素 

分 类 号：R969.4[医药卫生—药理学] R978.1[医药卫生—药学]