万古霉素对新生儿细菌性感染疾病的疗效及不良反应相关指标的评价  

Analysis of therapeutic efficay and adverse reactions of vancomycin in treatment of bacterial infection and its impact on renal function in neonates

作　　者：李俊瑶 李琴[1] 刘定远[1] 黎亮[1] Li Jun-yao;Li Qin;Liu Ding-yuan;Li Liang(Department of Pediatrics,Suining Central Hospital,Suining 629000,China)

机构地区：[1]遂宁市中心医院儿科,遂宁629000

出　　处：《中国药物应用与监测》2024年第2期168-171,共4页Chinese Journal of Drug Application and Monitoring

摘　　要：目的探索万古霉素对不同孕周新生儿细菌性感染的疗效和肾功能、听力损伤情况。方法回顾性收集2020年1月—2023年12月遂宁市中心医院新生儿科使用万古霉素新生儿41例,根据胎龄分为早产儿组(胎龄28~36周,n=23)和足月儿组(胎龄37~42周,n=18),比较2组有效率,治疗前后肾功能和听力损害情况。结果2组新生儿病原学检查送检率100.0%,早产儿组有效率(86.96%)与足月儿组有效率(94.99%)比较差异无统计学意义(P>0.05);2组万古霉素谷浓度[分别为(12.30±6.30)μg·mL^(-1)和(9.88±5.87)μg·mL^(-1)]比较差异无统计学意义(P>0.05);用药后两组血肌酐(Scr)和血尿素氮(BUN)均升高,早产儿组血Scr浓度[(43.02±18.98)μmol·L^(-1)]高于足月儿组[(32.45±10.64)μmol·L^(-1)],差异有统计学意义(P<0.05);早产儿组听力损害发生率(13.04%)与足月儿组(16.67%)差异无统计学意义,随访期其余新生儿听力无异常。结论万古霉素治疗早产儿和足月儿的有效率差异无统计学意义,对早产儿Scr影响更大,建议早产儿密切监测肾功能指标。Objective To investigate the therapeutic efficacy of vancomycin in treatment of bacterial infection in neonates of different gestational ages and its effects on renal function and hearing loss.Methods A retrospective study was conducted on 41 neonates who received treatment with vancomycin in our hospital from January 2020 to December 2023.They were divided into a preterm group(gestational age 28~36 weeks,n=23)and a full-term group(gestational age 37~42 weeks,n=18).The effective rate,renal function and hearing impairment after treatment were compared between the 2 groups.Results The submission rate of etiological examination in both groups were 100.0%,and the effective rate showed no statistically significant difference between the premature group(86.96%)and the full-term group(94.99%)(P>0.05).There was no statistically significant difference in the trough concentration of vancomycin between the two groups((12.30±6.30)μg·mL^(-1)vs(9.88±5.87)μg·mL^(-1)).After injection of vancomycin,the levels of serum creatinine(Scr)and blood urea nitrogen(BUN)were increased in both groups(P<0.05).The blood Scr in the preterm group((43.02±18.98)μmol·L^(-1))was higher than that in the full-term one((32.45±10.64)μmol·L^(-1)),and the difference was statistically significant(P<0.05).The incidence of hearing loss showed no statistically difference between the premature group and the full-term one(13.04%vs 16.67%,P>0.05).There was no additional abnormal hearing in the remaining children during the follow-up period.Conclusion Vancomycin exhibits promising efficacy in treatment of bacterial infection in both premature and full-term neonates.It elicits more changes on blood Scr in preterm infants.Therefore,it is recommended renal function be closely monitored for preterm infants.

关 键 词：万古霉素 新生儿 早产儿 肾功能 听性脑干反应 

分 类 号：R722.13[医药卫生—儿科] R969.3[医药卫生—临床医学]