儿科患者静脉注射万古霉素的血药浓度及其影响因素分析  

Analysis of Blood Drug Level of Intravenous Vancomycin and Its Influencing Factors in Pediatric Patients

作　　者：王凤娇[1] 王文娟 桂环[1] 颜颖慧 姚华 WANG Feng-jiao;WANG Wen-juan;GUI Huan;YAN Ying-hui;YAO Hua(Children's Hospital of Soochow University,Suzhou Jiangsu 215025,China)

机构地区：[1]苏州大学附属儿童医院,江苏苏州215025

出　　处：《抗感染药学》2022年第2期174-178,共5页Anti-infection Pharmacy

摘　　要：目的:分析儿科患者静脉注射万古霉素的血药浓度及其影响因素。方法:选取2017年1月1日—2019年12月31日苏州大学附属儿童医院收治的接受静脉注射推荐剂量的万古霉素治疗(每天40 mg/kg,分3次给药)且行治疗药物监测211例患儿作为研究对象,收集患儿的性别、年龄、感染类型、血尿素氮、血清肌酐和万古霉素谷浓度等临床资料,分析万古霉素血药浓度的影响因素,以及万古霉素对患儿肾功能的影响。结果:患儿的万古霉素血药浓度个体化差异较大,仅38.86%的患儿达到目标谷浓度,54.03%低于目标谷浓度;万古霉素血药浓度与年龄呈正相关(P<0.05),与肾小球滤过率水平呈负相关(P<0.05);年龄和肾小球滤过率水平均是儿童万古霉素血药浓度的影响因素。结论:患儿按指南推荐剂量给予万古霉素静脉治疗,可能不能确保其血药浓度达到目标谷浓度,临床应根据患儿的年龄和肾功能水平进行个性化调整,保证治疗的有效性。Objective: To analyze the blood drug level of intravenous vancomycin and its influencing factors in pediatric patients. Methods: A total of 211 children who received intravenous vancomycin at the recommended dose(40 mg/kg per day, divided into three times) and underwent therapeutic drug monitoring were selected in the Children’s Hospital of Soochow University from January 1, 2017 to December 31, 2019. The clinical data of children, including gender, age, infection type, blood urea nitrogen, serum creatinine and minimum concentration of vancomycin, were collected to analyze the influencing factors of vancomycin concentration and the effect of vancomycin on renal function.Results: The individual differences of vancomycin concentration in children were large, only 38.86% of children reached the target concentration, and 54.03% were lower than the target concentration. The blood drug level of vancomycin was positively correlated with age(P<0.05), and negatively correlated with glomerular filtration rate(P<0.05), so age and glomerular filtration rate were the influencing factors of vancomycin concentration in children. Conclusion: The treatment with vancomycin at the recommended dose may not ensure that the blood drug level of vancomycin reaches the target concentration. Therefore, the personalized adjustment should be made according to the age and renal function of the children to ensure the effectiveness of treatment.

关 键 词：万古霉素 血药浓度 患儿 肾功能 年龄 

分 类 号：R97[医药卫生—药品]