万古霉素血清谷浓度监测及临床应用分析

发布时间：2018-09-17 08:39

【摘要】：目的观察本院重症监护病房(ICU)患者万古霉素临床应用及血清谷浓度监测的现状。方法用荧光偏振免疫法测定万古霉素血清谷浓度,回顾性的对204例入住ICU且进行万古霉素血清谷浓度患者的基础疾病、病原学结果、万古霉素血清谷浓度、疗效、肾功能情况等进行统计分析。结果细菌分离率为25.6%,针对病原微生物的治疗为41.6%,临床治愈率为70.6%;204例患者共进行万古霉素血清谷浓度测定275例次,血清谷浓度为1.11~50μg·m L~(-1),平均血清谷浓度(13.32±8.40)μg·m L~(-1),靶浓度为15~20μg·m L~(-1),达标率为14.5%。因数据不全无法判定肾毒性者4例(2.0%),出现肾毒性者42例(20.6%)。结论 204例患者血清谷浓度在有效范围内的比例偏低,对ICU患者需重视血药浓度监测,并结合重症患者的临床实际实现个体化给药。
[Abstract]:Objective to observe the clinical application of vancomycin and the monitoring of serum grain concentration in (ICU) patients in intensive care unit. Methods the serum valley concentration of vancomycin was determined by fluorescence polarization immunoassay. The basic diseases of 204 patients who were admitted to ICU and were treated with vancomycin serum valley concentration were retrospectively studied. The etiological results, the serum valley concentration of vancomycin, the curative effect of vancomycin were analyzed. The renal function was analyzed statistically. Results the isolation rate of bacteria was 25.6, the treatment of pathogenic microorganism was 41.6 and the clinical cure rate was 70.6204 patients. 275 cases of vancomycin serum valley concentration were measured, the mean serum grain concentration was 1.1150 渭 g mL ~ (-1), the mean serum grain concentration was (13.32 卤8.40) 渭 g mL ~ (-1), the target concentration was 1520 渭 g mL ~ (-1), the reaching rate was 14.5B. There were 4 cases (2.0%) with nephrotoxicity and 42 cases (20.6%) with nephrotoxicity due to incomplete data. Conclusion the ratio of serum grain concentration in the effective range is low in 204 patients. It is necessary to pay attention to the monitoring of serum drug concentration in patients with ICU and to realize individualized administration in combination with the clinical practice of severe patients.
【作者单位】：中国医科大学附属盛京医院呼吸科;中国医科大学附属盛京医院重症医学科;
【分类号】：R969

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