不同给药剂量替考拉宁血药浓度监测结果及影响因素分析  

Analysis of the Teicoplanin Serum Trough Concentration Result and Influencing Factors in Different Dosages Administration

作　　者：蔡婕 刘香芳[1] 倪穗琴[1] CAI Jie;LIU Xiangfang;NI Suiqin(Guangzhou First People’s Hospital,Guangzhou,Guangdong 510180,China)

机构地区：[1]广州市第一人民医院,广东广州510180

出　　处：《今日药学》2020年第8期565-568,共4页Pharmacy Today

基　　金：广东省医学科学技术研究基金(A2019572)。

摘　　要：目的分析替考拉宁在不同给药剂量患者中血药浓度监测结果及影响因素,为临床治疗提供客观依据,实现个体化给药。方法回顾性分析广州市第一人民医院2018年12月~2019年11月使用替考拉宁的69例患者,按不同给药剂量分为标准剂量组(GS)400 mg和高剂量组(GH)800 mg,分析两组组人群血药谷浓度结果、达标率和临床资料等,并采用SPSS软件进行逐步回归分析影响血药浓度的主要因素。结果69例次血药浓度平均水平为(25.04±6.11)mg·L^-1,其中GS组29例,平均血药浓度为(20.72±10.80)mg·L^-1;GH组40例,平均血药浓度为(29.36±16.75)mg·L^-1,两组血药浓度差异具有统计学意义(P<0.05)。两组浓度达标率分别为82.76%和92.50%,无统计学意义(P=0.212)。逐步回归分析结果显示GS组血药浓度水平受性别、年龄和肌酐清除率的影响。GH组除上述影响因素外,还受血清白蛋白的影响。结论替考拉宁应重视给予足够的负荷剂量,以尽快达到稳态血药浓度,提高临床疗效;同时其血药浓度受多方面的影响,应及时进行治疗药物监测,调整药物剂量,以达到个体化治疗的目的。OBJECTIVE To investigate the serum trough concentration result and influencing factors of teicoplanin in different dosages patients,aiming to provide objective basis for clinical treatment and achieve individual drug administration.METHODS Patients(69 cases)who took teicoplanin from December 2018 to Novermber 2019 were enrolled in a retrospective study and divided into standard-dose group(GS)400 mg and high-dose group(GH)800 mg,then the serum trough concentration result and clinical data were analyzed.A stepwise linear regression method was used to explore the relationship between the teicoplanin concentration and other factors by SPSS.RESULTS The mean serum trough concentration of 69 cases was(25.04±6.11)mg·L^-1,29 cases were enrolled in GS,t he mean Cmin was(20.72±10.80)mg·L^-1.40 cases were enrolled in GH,the mean Cmin was(29.36±16.75)mg·L^-1.There was a statistically significant difference in the serum trough concentration between GS and GH(P<0.05).The rate of effective serum trough concentration was 82.76%and 92.50%with no statistically significant difference(P=0.212).The result of stepwise linear regression showed that teicoplanin concentration was related with gender,age and creatinine clearance rate in GS.In addition,serum albumin was also the factor affecting the serum trough concentration in GH.CONCLUSION To improve clinical efficacy,enough loading dose of teicoplanin should be paid attention to give to reach the target concentration as soon as possible.Because of plasma concentration affected by many factors,it is recommended to monitor the plasma concentration to adjust drug dosage and achieve individual treatment.

关 键 词：替考拉宁 血药浓度 负荷剂量 影响因素 

分 类 号：R969[医药卫生—药理学]