老年患者大剂量使用万古霉素血药浓度监测结果及肾毒性分析

发布时间：2018-02-02 15:39

本文关键词： 万古霉素血药谷浓度老年患者　出处：《中国医院药学杂志》2015年18期 　论文类型：期刊论文

【摘要】：目的:了解老年患者大剂量使用万古霉素的血药浓度情况以及对肾功能的影响。方法:51例老年感染患者给予万古霉素1 g静滴q12h,对万古霉素血清谷浓度以及治疗前后相关肾功能指标进行统计分析。结果:采用万古霉素1 g静脉滴注q12h的给药剂量,56.9%老年患者血药谷浓度超过20 mg·L-1,并且治疗前后血肌酐值有统计学差异(P0.05);无论患者肾功能是否正常,给予万古霉素1 g 12h治疗前后内生肌酐清除率有有统计学差异(P0.05)。结论:老年患者用万古霉素抗感染治疗时,经验性给予1 g q12h的剂量,初步观察到血药谷浓度很可能会超过参考范围,并会引起肾功能的损害,但本研究样本量小,仍需大样本的进一步研究论证。
[Abstract]:Objective: to investigate the blood concentration of vancomycin and its effect on renal function in elderly patients. Methods: 51 cases of senile infection were given vancomycin 1 g iv Q12h, and the serum grain concentration of vancomycin and its treatment were treated with vancomycin. Results: the dosage of vancomycin 1 g iv for 12 h was 56.9% or more than 20 mg 路L -1 in elderly patients, and the serum creatinine level was significantly different before and after treatment (P 0.05). Is the patient's renal function normal, There was significant difference in the clearance rate of endogenous creatinine before and after 1 g of vancomycin for 12 hours. Conclusion: when the elderly patients were treated with vancomycin, the dose of 1 g q12 h was given empirically. It was preliminarily observed that the concentration of drug grain in blood may exceed the reference range and cause damage to renal function. However, the sample size of this study is small, and the further study of large sample is needed.
【作者单位】：昆明医科大学第一附属医院临床药学科;
【分类号】：R969.3
【正文快照】： 万古霉素为糖肽类抗生素,是治疗耐甲氧西林金黄色葡萄球菌(MRSA)和其他革兰阳性菌感染的一线用药。长期以来,临床一直把万古霉素血清谷浓度控制在5~10 mg·L-1作为目标浓度,但是,随着葡萄球菌等菌株对万古霉素的MIC值漂移,之前的目标浓度已不能有效控制感染。美国感染病学会制

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