革兰阳性菌重症感染幼儿利奈唑胺血药浓度监测对疗效和安全性的影响  

Effect of plasma concentration monitoring of linezolid on efficacy and safety in children with severe Gram-positive bacteria infection

作　　者：雷雪 冯雪影[1] 白海昕[1] LEI Xue;FENG Xue-ying;BAI Hai-xin(Clinical Pharmacy of Daqing Longnan Hospital(the Fifth Affiliated Hospital of Qiqihar Medical College),Daqing 163453,China)

机构地区：[1]大庆龙南医院(齐齐哈尔医学院第五附属医院)临床药学,黑龙江大庆163453

出　　处：《中国处方药》2024年第8期5-8,共4页Journal of China Prescription Drug

基　　金：2023年大庆市指导性科技计划项目(医疗)(zdy-2023-04)。

摘　　要：目的分析革兰阳性菌重症感染幼儿利奈唑胺血药浓度监测对疗效和安全性的影响。方法选取2020年1月~2023年12月收治的80例革兰阳性菌重症感染患儿,随机分为2组,对照组(40例)进行常规利奈唑胺治疗,研究组(40例)初始进行常规利奈唑胺治疗,治疗1 d后对其进行血药浓度监测,并根据血药浓度监测结果结合患儿综合情况调整药物剂量,给出个体化治疗方案,评估两组治疗效果、革兰阳性菌清除率并进行安全性分析。结果治疗前,两组白细胞计数(WBC)、C反应蛋白(CRP)、丙氨酸氨基转移酶(ALT)、血尿素氮(BUN)、肌酐(Cr)水平差异无统计学意义(P>0.05);治疗后,两组ALT、BUN、Cr水平差异无统计学意义(P>0.05),治疗后研究组WBC、CRP水平低于对照组(P<0.05);治疗后对照组革兰阳性菌清除29例,清除率为72.50%,研究组革兰阳性菌清除36例,清除率为90.00%,研究组革兰阳性菌清除率高于对照组(χ^(2)=4.021,P=0.045);研究组总有效率高于对照组(P<0.05);研究组不良反应发生率低于对照组(P<0.05)。结论治疗革兰阳性菌重症感染患儿时,根据利奈唑胺血药浓度监测结果进行剂量调整可提高利奈唑胺治疗效果及革兰阳性菌清除率,降低患儿炎症因子水平,减少不良反应发生。Objective To analyze the effect and safety of blood concentration monitoring of linezolid in children with severe Gram-positive bacteria infection.Methods A total of 80 children with severe Gram-positive bacterial infection admitted from January 2020 to December 2023 were randomly divided into two groups.The control group(40 cases)received routine linezolid treatment,and the study group(40 patients)initially received routine linezolid treatment,the blood concentration monitored was performed after 1 d of treatment,and the dose of linezolid was adjusted according to the blood concentration monitoring results combined with the comprehensive situation of the children,and the individualized treatment plan was given.The therapeutic effect and the clearance rate of Gram-positive bacteria in the two groups were evaluated,and the safety was analyzed.Results There was no significant difference in the levels of WBC,CRP,ALT,BUN and Cr between the two groups before treatment(P>0.05);and there was no significant difference in the levels of ALT,BUN and Cr between the two groups after treatment(P>0.05).After treatment,the levels of WBC and CRP in the study group were lower than those in the control group(P<0.05).After treatment,29 casas of Gram-positive bacteria were cleared in the control group,with a clearance rate of 72.50%,and 36 cases of Gram-positive bacteria were cleared in the study group,with a clearance rate of 90.00%.The clearance rate of Gram-positive bacteria in the study group was higher than that in the control group(χ^(2)=4.021,P=0.045).The total effective rate of the study group was higher than that of the control group(P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group(P<0.05).Conclusion When treating children with severe Gram-positive bacteria infection,dose adjustment according to the results of linezolid blood concentration monitoring can improve the therapeutic effect of linezolid and the clearance rate of Gram-positive bacteria,reduce the level of infla

关 键 词：利奈唑胺 革兰阳性菌 血药浓度 疗效评价 

分 类 号：R969.1[医药卫生—药理学]