ICU患者血浆中去甲万古霉素浓度监测及临床用药相关性分析

发布时间：2018-08-18 11:58

【摘要】：目的:分析去甲万古霉素血药浓度监测情况,为临床合理用药提供依据。方法:采用HPLC-UV法测定去甲万古霉素的血药浓度,对2015年1~4月ICU病房患者105例次去甲万古霉素血药浓度监测结果进行研究和分析。结果:30例次去甲万古霉素血浆谷浓度在治疗窗范围(10~20 mg·L~(-1))内,占28.57%;49例次达到中毒浓度(20 mg·L~(-1)),占46.67%。60岁以上组与40岁以下组比较,谷浓度有统计学差异(P0.05);肾功能中、重度损害组与肾功能正常组比较,谷浓度有统计学差异(P0.05),且肾功能重度损害组中毒浓度比例达100%。结论:去甲万古霉素血药浓度个体差异较大,应进行血药浓度监测,特别是对于老年及肾功能损害患者,应常规监测并实现个体化用药,以保证临床用药安全有效。
[Abstract]:Objective: to analyze the blood concentration of norvancomycin and provide evidence for rational drug use. Methods: the blood concentration of norvancomycin was determined by HPLC-UV method. The results of monitoring the blood concentration of norvancomycin in 105 patients in ICU ward from January to April 2015 were studied and analyzed. Results the plasma valley concentration of norvancomycin in 30 cases was within the treatment window (10 ~ 20 mg / L ~ (-1), accounting for 28.57 ~ (-1) times. (20 mg / L ~ (-1), was 46.67 ~ (-1) in the group over 60 years of age, and there was a significant difference between the group under 40 years of age (P0.05); in renal function, there was a significant difference between the two groups (P < 0.05). Compared with normal renal function group, there was significant difference in valley concentration between severe injury group and normal renal function group (P0.05), and the proportion of toxic concentration in severe renal function injury group was 100. Conclusion: the blood concentration of norvancomycin varies greatly, so it is necessary to monitor the concentration of norvancomycin in blood, especially in elderly patients and patients with renal function damage, so as to ensure the safety and effectiveness of clinical use of vancomycin.
【作者单位】：河北医科大学第四医院;石家庄市人民医院;河北医科大学;
【基金】：河北省卫生厅医学科学研究重点课题项目(20100122) 河北省中医药管理局科研计划项目(2013161) 河北省人力资源和社会保障厅留学回国人员科技活动择优资助项目(20100313)
【分类号】：R459.7

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