替考拉宁在重症肺炎患者中的血药浓度监测与应用分析

发布时间：2018-06-19 22:20

本文选题：替考拉宁 + 高效液相色谱法　；参考：《中国医院药学杂志》2017年21期

【摘要】：目的:评价分析替考拉宁在重症肺炎患者中的血药浓度范围及临床疗效。方法:前瞻性纳入某院重症医学科重症肺炎且需使用替考拉宁治疗的患者,给予替考拉宁常规负荷剂量(400 mg,q 12 h,3剂)以及维持剂量(400 mg,qd),给药后第5天收集替考拉宁稳态谷浓度血样,运用高效液相色谱法监测其浓度,统计分析血药浓度与临床疗效、细菌学有效率以及不良反应的相关性。采用SPSS 19.0对本研究数据进行处理。结果:替考拉宁在4~100μg·mL~(-1)范围内线性关系良好,标准曲线回归方程为:Y=6 471.14X-2 065.43,R~2=0.999 6,平均日内精密度和日间精密度RSD为3.35%和4.66%,稳定性试验RSD为5.13%。平均提取回收率和方法回收率为82.71%和98.34%。共62例重症肺炎患者纳入本研究,替考拉宁平均稳态谷浓度为(11.98±4.82)μg·mL~(-1),总体临床有效率为64.52%,细菌学有效率为66.13%,7例(11.29%)出现肾功能损伤,4例(6.45%)出现肝功能损伤。质量浓度10μg·mL~(-1)22例,占35.48%,浓度15μg·mL~(-1)的45例,占72.58%。Logistic回归分析显示替考拉宁谷浓度与细菌学有效率以及肾毒性分别具有独立相关性,并确定目标谷浓度范围为9~17μg·mL~(-1)。结论:对于重症肺炎患者,为保证临床疗效建议适当增加替考拉宁给药剂量,必要时可开展血药浓度监测,使其有效浓度维持在9~17μg·mL~(-1)范围。
[Abstract]:Objective: to evaluate the range and clinical efficacy of teicoplanin in patients with severe pneumonia. Methods: patients with severe pneumonia who were included in the department of intensive care in a hospital and who needed to be treated with teicoplanin, Teicoplanin was administered at a conventional load dose of 400 mg / Q 12 h) and at a maintenance dose of 400 mg / kg QD. Blood samples of teicoplanin steady-state valley concentration were collected on the 5th day after administration. The concentrations of teicoplanin were monitored by high performance liquid chromatography (HPLC), and the blood concentration and clinical efficacy were statistically analyzed. Bacteriological efficacy and the correlation of adverse reactions. SPSS 19.0 was used to process the data. Results: the calibration curve of teicoplanin was linear in the range of 4 ~ 100 渭 g / mL ~ (-1). The regression equation of the standard curve was: 1 / Y ~ (6) 471.14X-2 065.43 ~ (-1) RX _ (2) 0.999 6. The average intra-day and inter-day precision RSD were 3.35% and 4.66%, and the RSD for stability test were 5.13% and 4.66%, respectively. The average recovery and method recovery were 82.71% and 98.34% respectively. A total of 62 patients with severe pneumonia were included in this study. The mean steady-state valley concentration of teicoplanin was 11.98 卤4.82 渭 g / mL / L, the overall clinical effective rate was 64.52 and the bacteriological effective rate was 66.1313 / 7 (11.29). There were 22 cases (35.48g / kg, 15 渭 g / ml) of 10 渭 g / mL ~ (-1) (P < 0.05). Logistic regression analysis showed that the concentration of teicoplanin was independently correlated with the bacteriological effective rate and nephrotoxicity, and the range of target valley concentration was 917 渭 g / mL ~ (-1). Conclusion: for the patients with severe pneumonia, in order to ensure the clinical curative effect, it is suggested that the dosage of teicoplanin should be increased properly, and the serum concentration of teicoplanin should be monitored if necessary to keep its effective concentration within the range of 9 ~ 17 渭 g / mL ~ (-1).
【作者单位】：广州医科大学附属第一医院;佛山市南海区第六人民医院;南方医科大学第三附属医院;
【基金】：广州医科大学博士或留学回国人员科研项目(编号:2014C28) 广东省医院药学科研基金(编号:2015SW06)
【分类号】：R969

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