尿量对腹膜透析相关性腹膜炎患者万古霉素血药浓度及腹腔给药剂量的影响研究  

The effect of urine volume on the blood concentration and intraperitoneal administration of vancomycin dose in patients with peritoneal dialysis associated peritonitis

作　　者：刘俊梅[1] 李福林 殷效龙 吴丽华[3] LIU Junmei;LI Fulin;YIN Xiaolong;WU Lihua(Department of Pharmacy,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Tiansheng Health Service Station,General Hospital of Ningxia Medical University,Yinchuan 750004 China;Department of Nephrology,General Hospital of Ningxia Medical University,Yinchuan 750004 China)

机构地区：[1]宁夏医科大学总医院药剂科,宁夏银川750001 [2]宁夏医科大学总医院天盛社区卫生服务站,宁夏银川750001 [3]宁夏医科大学总医院肾脏内科,宁夏银川750001

出　　处：《宁夏医学杂志》2024年第11期976-978,共3页Ningxia Medical Journal

基　　金：宁夏自然科学基金项目(2021AAC03383)。

摘　　要：目的 分析腹膜透析相关性腹膜炎患者24 h尿量对万古霉素血药浓度及给药剂量的影响。方法 采用回顾性研究方法,筛选出符合条件的采用万古霉素经验治疗或目标治疗的腹膜透析相关性腹膜炎患者共计41例,根据24 h尿量将患者分为无尿组(尿量<100 mL)16例、少尿组(100 mL≤尿量<400 mL)15例和有尿组(尿量≥400 mL)10例,记录患者一般资料、24 h尿量、eGFR、万古霉素血药浓度、浓度达标时给药剂量,分析尿量对万古霉素血药浓度及给药剂量的影响。结果 共收集65名腹膜透析相关性腹膜炎患者,有41例患者数据纳入研究。3组患者万古霉素血药浓度(谷浓度)分别为(19.18±10.38)mg/L、(12.97±2.08)mg/L、(11.30±3.78)mg/L,与无尿组相比,少尿组和有尿组万古霉素血药浓度显著降低(P<0.05);万古霉素血药浓度达标时,3组给药剂量分别为(4.27±1.09)mg/(kg·d^(-1))、(4.46±0.69)mg/(kg·d^(-1))、(4.92±1.07)mg/(kg·d^(-1)),与无尿组相比,有尿组万古霉素血药浓度达标时给药剂量更高(P<0.05)。Pearson相关性分析结果显示,24 h尿量与万古霉素血药浓度呈负相关(r=-0.462,P<0.05)。结论 24 h尿量会显著影响腹膜透析相关性腹膜炎患者万古霉素血药浓度及给药剂量,在腹膜透析相关性腹膜炎患者中应用万古霉素时应考虑残余肾功能情况。Objective To explore the effect of 24-hour urine volume on the blood concentration and dosage of vancomycin in patients with peritoneal dialysis associated peritonitis.Methods Using a retrospective study method,a total 41 eligible patients with peritoneal dialysis related peritonitis treated empirical or on target with vancomycin were screen.The patients were divided into 16 cases in no urine group(urine volume<100 ml),15 cases in the oliguria group(100 mL≤urine volume<400 mL),and 10 cases in the presence of urine group(urine volume≥400 mL)based on 24 h urine volume.The general data of the patients were recorded,24-hour urine volume,eGFR,vancomycin blood concentration,and the dose of vancomycin administered when the concentration reached the standard were recorded.The effects of urine volume on vancomycin blood concentration and the dose of vancomycin administered were analyzed.Results A total of 65 patients with peritoneal dialysis-associated peritonitis were collected,41 patients data were included in the study.The vancomycin blood concentrations(trough concentrations)in three groups of patients were(19.18±10.38)mg/L,(12.97±2.08)mg/L and(11.30±3.78)mg/L respectively.Compared with the group without urine Vancomycin blood concentration was significantly lower in the oliguria group and the group with urine compared to the group without urine(P<0.05).Vancomycin blood concentration was achieved at(4.27±1.09)mg/(kg·d^(-1))、(4.46±0.69)mg/(kg·d^(-1)),(4.92±1.07)mg/(kg·d^(-1))in the three group.a higher dosage of vancomycin was administered at the vancomycin blood concentration level in the group with urine compared with that in the group without urine(P<0.05).Pearson correlation analysis showed that 24 h urine volume was negatively correlated with vancomycin concentration(r=-0.462,P<0.05).Conclusion 24-hour urine output could affect the blood concentration and dosage of vancomycin in patients with peritoneal dialysis associated peritonitis.Residual renal function should be considered when using vancomyci

关 键 词：24 h尿量 腹膜透析相关性腹膜炎 万古霉素 残余肾功能 

分 类 号：R572.2[医药卫生—消化系统]