万古霉素在不同体重新生儿中血药浓度分布情况分析  

Analysis of Vancomycin in Blood Concentration of Newborns in Different Weights

作　　者：欧阳颖[1] 沈乐 张羚枚 唐淑敏 周瑞瑜 谢心怡 阮扬皓 OUYANG Ying;SHEN Le;ZHANG Ling-mei;TANG Shu-min;ZHOU Rui-yu;XIE Xin-yi;RUAN Yang-hao(Department of paediatrics,SUN YAT-SEN Memorial Hospital,SUN YA-SEN University,GuangZhou,510120)

机构地区：[1]中山大学孙逸仙纪念医院儿科,510120

出　　处：《岭南急诊医学杂志》2021年第6期617-621,共5页Lingnan Journal of Emergency Medicine

基　　金：广东省广州市民生科技攻关计划项目(201903010079)。

摘　　要：目的:了解万古霉素在不同体重新生儿患者中血药浓度分布情况,为万古霉素在新生儿感染性疾病的应用上提供剂量及方法上的指导。方法:纳入中山大学孙逸仙纪念医院2015年1月至2020年1月使用万古霉素进行血药浓度监测的新生儿,收集新生儿在不同用药体重的万古霉素血药浓度监测数据。结果:纳入符合标准的236例患儿中,初始剂量万古霉素平均浓度为(13.69±6.53)mg/L,总体浓度达标率为50.85%,58例经调整用药方式达到目标谷浓度,最终总体浓度达标率为75.42%。当新生儿体重<1.0 kg时,q12h给药,8-10 mg/kg剂量组的万古霉素浓度达标率最高(57.14%)58例;q8h给药时,10-12 mg/kg剂量组浓度达标率最高(100%)。当体重在1.0-1.5 kg时,q12h给药,6-8 mg/kg剂量组达标率最高(66.67%);q8h给药,8-10 mg/kg剂量组浓度达标率最高(76.92%)。当体重在1.5-2.5 kg时,q12h给药,8⁃<10 mg/kg剂量组浓度达标率最高(53.85%);q8h给药,6-8 mg/kg剂量组浓度达标率最高(88.89%)当体重在2.5-4.0 kg时,q12h给药,10-12 mg/kg剂量组浓度达标率最高(43.48%);q8h给药,16-18 mg/kg剂量组浓度达标率最高(80.00%)。结论:万古霉素的血药浓度的个体差异性大,既往经验剂量的血药浓度偏大,为保障不同体重新生儿的用药安全,需要个体化用药,及时监测血药浓度,使其维持在安全有效范围内。Objective:To investigate the plasma concentration distribution of vancomycin in neonates of different weights,and to provide a reference for the application of vancomycin in infectious neonates.Methods:Newborns who were administered with vancomycin and received the plasma drug concentration monitoring in The Sun Yat⁃sen Hospital,Sun Yat⁃sen University from January 2015 to January 2020 were enrolled.This study collected the monitoring data of vancomycin plasma concentration in newborns with different medication weights and different birth ages.Results:In 236 neonates who met the criteria,the average concentration of vancomycin was(13.69±6.53)mg/L and the overall concentration compliance rate was 50.85%,58 neonates searched the required standard after adjusting medication.The final overall concentration compliance rate was 75.42%.After adjusting medication,when the neonatal weight was less than 1.0 kg and dosing at every 12 hours,the vancomycin concentration compliance rate in the 8-10 mg/kg dose group was the highest(57.14%).And when dosing at every 8 hours,the concentration compliance rate of 10-12 mg/kg dose group was the highest(100%).When the neonatal weight was between 1.0 kg and 1.5 kg and dosing at every 12 hours,the vancomycin concentration compliance rate in the 6-8 mg/kg dose group was the highest(66.67%).And when dosing at every 8 hours,the concentration compliance rate of 8-10 mg/kg dose group was the highest(76.92%).When the neonatal weight was between 1.5 kg and 2.5 kg and dosing at every 12 hours,the vancomycin concentration compliance rate in the 8-10 mg/kg dose group was the highest(53.85%).And when dosing at every 8 hours,the concentration compliance rate of 6-8 mg/kg dose group was the highest(88.89%).When the neonatal weight was between 2.5 kg and 4.0 kg and dosing at every 12 hours,the vancomycin concentration compliance rate in the 10⁃<12 mg/kg dose group was the highest(43.48%).And when dosing at every 8 hours,the concentration compliance rate of 16⁃<18 mg/kg dose group was the high

关 键 词：万古霉素 新生儿 血药浓度 用药分析 

分 类 号：R969.1[医药卫生—药理学]