目的 研究影响比阿培南临床疗效的主要因素，为临床用药实践提供基础。方法 回顾性分析2020年3月—2022年3月入住南京大学医学院附属鼓楼医院并进行比阿培南治疗药物监测的患者，根据临床结局将患者分为7 d临床有效组（有效组）和7 d临床无效组（无效组），结合患者药物浓度及相关临床数据进行Logistic回归分析。结果 共纳入111例患者，其中有效组69例，无效组42例。Logistic分析结果显示，影响临床疗效的因素有：比阿培南谷浓度≥1.95 μg·mL^-1［比值比（OR）＝8.78，95%置信区间（95% CI）：3.29～23.42，P＜0.001）；白蛋白（ALB）≥31.05 g·L^-1（OR＝3.77，95% CI：1.29～10.93，P＝0.015）；初始C反应蛋白（CRP）≤57.6 mg·L^-1（OR＝4.31，95% CI：1.53～12.15，P＝0.006）。结论 比阿培南谷浓度、ALB及初始CRP水平对比阿培南的临床疗效有显著影响，在进行治疗药物监测的同时需密切关注患者的基础病情及感染严重程度，优化临床治疗方案。

Objective To investigate the main factors influencing the clinical efficacy of biapenem, including the clinically effective biapenem trough concentration cut-off values, and to provide evidence for the optimization of dosing. Methods Retrospective analysis was performed on patients admitted to Drum Tower Hospital Affiliated to Medical School of Nanjing University from March 2020 to March 2022 who underwent therapeutic drug monitoring during treatment with biapenem. Patients were divided into 7-day clinical effective group (effective group) and 7-day clinical ineffective group (ineffective group) according to the clinical results, and logistic regression analysis was performed based on drug concentration and related clinical data. Results A total of 111 patients were included, with 69 cases in the effective group and 42 cases in the ineffective group after seven days of treatment. Logistic analysis results showed that the factors influencing the 7-day clinical efficacy were: The trough concentration of biapenem ≥ 1.95 μg·mL^-1 (OR = 8.78, 95%CI: 3.29—23.42, P < 0.001), ALB ≥ 31.05 g·L^-1 (OR = 3.77, 95%CI: 1.29—10.93, P = 0.015), initial CRP ≤ 57.6 mg·L^-1 (OR = 4.31, 95%CI: 1.53—12.15, P = 0.006). Conclusion The biapenem trough concentration, ALB and initial CRP levels were significantly associated with clinical efficacy, and it is important to closely monitor the patient's underlying condition and severity of infection while conducting therapeutic drug monitoring to optimize clinical treatment.

R978.1

国家重点研发计划资助项目（2020YFC2008303）