老年患者万古霉素AUC_(0-24h)的监测与分析  

Analysis of monitoring results of vancomycin AUC_(0-24h)in elderly patients

作　　者：冯朴琼 吴晖[1] 何瑾[1] FENG Puqiong;WU Hui;HE Jin(Center of Clinical Pharmacy,The First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院临床药学中心,昆明650032

出　　处：《中国临床药学杂志》2024年第8期610-614,共5页Chinese Journal of Clinical Pharmacy

基　　金：云南省基础研究计划(昆明医科大学联合专项)项目(编号202101AY070001-091)。

摘　　要：目的探讨AUC0-24h作为万古霉素监测靶目标在老年患者中的应用及临床意义。方法回顾性收集符合入选标准的265例老年患者的临床资料,对感染诊断情况、万古霉素用药情况及AUC0-24h达标情况等进行分析。结果265例老年患者中,AUC0-24h监测结果在目标范围之内(400~650 mg·h·L^(-1))的占35.1%,低于目标范围的占55.1%。在不同给药方案中,AUC0-24h的达标率差异无统计学意义(P>0.05);按不同肌酐清除率进行区组分析,AUC0-24h达标率之间差异有统计学意义(P<0.05),其中肌酐清除率<30 mL·min^(-1)组及30~39.99 mL·min^(-1)组的AUC0-24h达标率较高,而肌酐清除率≥40 mL·min^(-1)的老年患者AUC0-24h达标率为30%左右。结论我院老年患者万古霉素AUC0-24h达标率低。临床药师可通过治疗药物监测的方法提供药学服务,优化万古霉素给药方案。AIM To explore the application and clinical significance of AUC_(0-24h)as the target of vancomycin monitoring in elderly patients.METHODS The clinical data of 265 elderly patients who met the inclusion criteria were collected retrospectively,and the infection diagnosis,vancomycin use and AUC_(0-24h)compliance were analyzed.RESULTS Among 265 elderly patients,35.1%of the AUC_(0-24h)monitoring results were within the target range(400-650 mg·h·L^(-1)),and 55.1%were below the target range.There was no statistically significant difference in the rates of reaching the standard of AUC_(0-24h)of different administration schemes(P>0.05).When analyzed by stratified groups based on different creatinine clearance rates,the differences in the rates of reaching the standard of AUC_(0-24h)were statistically significant(P<0.05).The AUC_(0-24h)compliance rate of the groups with creatinine clearance rate<30mL·min^(-1)and 30-39.99 mL·min^(-1)was higher.For the elderly patients with creatinine clearance rate≥40 mL·min^(-1),the rate of reaching the standard of AUC_(0-24h)was about 30%.CONCLUSION The compliance rate of vancomycin AUC_(0-24h)in elderly patients in our hospital is low.Clinical pharmacists can provide pharmaceutical services through therapeutic drug monitoring to optimize the vancomycin administration plan of clinical treatment.

关 键 词：万古霉素 AUC0-24h 老年患者 

分 类 号：R969[医药卫生—药理学]