万古霉素是治疗耐甲氧西林金黄色葡萄球菌的首选药，但在使用万古霉素的过程中，血药浓度过低会导致治疗效果不佳、过高会出现耳和肾毒性，且体内代谢个体差异大，易受患者的年龄、体质量、肝肾功能、基础疾病状态、给药间隔时间和重症感染等多种因素的影响。因此为了保证治疗有效性和安全性，临床常采取血药浓度监测来指导万古霉素个体化用药。从万古霉素血药浓度监测与疗效和不良反应的相关性，目前常用的药物监测方法（包括高效液相色谱、超高效液相色谱串联质谱法、免疫分析法等），不同人群万古霉素血药浓度的影响因素等方面进行了归纳总结，以期为该药的临床合理应用提供指导。

The vancomycin is the first choice for treatment of methicillin-resistant staphylococcus aureus drugs, but in the use of vancomycin in the process of blood drug concentration is too low will lead to poor treatment effect, can appear high ear and renal toxicity, and metabolic individual difference is big, vulnerable to the patient's age, body mass, liver and kidney function, basic disease states, dosing interval and the influence of many factors such as severe infection, so in order to guarantee the treatment efficacy and safety. Blood concentration monitoring is often used to guide the individualized administration of vancomycin. The correlation between vancomycin plasma concentration monitoring and efficacy and adverse reactions, the commonly used monitoring methods (including high performance liquid chromatography, ultra performance liquid chromatography tandem mass spectrometry, immunoassay, etc.), and the influencing factors of vancomycin plasma concentration in different populations were summarized, providing guidance for tclinical rational drug use of vancomycin.

R978.1

昆明市卫生健康委员会卫生科研课题资助项目（2019-13-05-001）