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[摘要]
目的 分析万古霉素血药浓度监测结果及临床应用情况,为临床合理用药提供参考。方法 采用反相-高效液相色谱法测定万古霉素血药浓度,对万古霉素血药浓度监测结果及相关用药信息进行比较分析。结果 万古霉素谷浓度监测202次,平均血药谷浓度(14.36±8.12)mg/L,浓度小于10 mg/L的有68例次(33.66%),在10~20 mg/L的有100例次(49.51%),大于20 mg/L的有34例次(16.83%);肾功能正常与异常组间,血药谷浓度有显著性差异;用药前后,各项肾功能指标无显著性差异。结论 万古霉素个体差异大,需加强血药浓度监测;针对肾功能异常患者,临床医生和药师需审慎评估给药剂量;临床医生应根据血药浓度及时调整用药方案,实现个体化给药。
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[Abstract]
Objective To analyze the clinical application and serum concentration monitoring of vancomycin, in order to provide references for rational clinical usage. Methods Reversed phase high performance liquid chromatography was used to determine serum concentration of vancomycin by means of comparative analysis on serum concentration monitoring results and related information of drug use. Results Totally 202 cases of vancomycin serum concentration were monitored. The average trough concentration of vancomycin was (14.36±8.12) mg/L. There were 68 cases (33.66%) lower than 10 mg/L, 100 cases (49.51%) of 10-20 mg/L, and 34 cases (16.83%) over 20 mg/L. For patients with normal renal function and impaired renal function, the difference of trough concentration was statistically significant. Compared of blood urea nitrogen, serum creatinine, cystatin C and creatinine clearance before and after treatment of vancomycin, with no significant difference. Conclusion Due to the large individual difference, it is very important to strengthen serum vancomycin concentration monitoring in clinic. For patients with impaired renal function, clinicians and pharmacists should assess the dosage regimen of vancomycin cautiously. Clinicians need to modulate the dosage regimen and implement individualized medication according to vancomycin serum concentration.
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