摘要
目的 研究老年患者使用万古霉素的肾毒性及影响肾毒性发生的各种因素。方法 选择 2 2例因肺部感染或肾盂肾炎并且其致病菌对万古霉素敏感 ,而静脉使用万古霉素的老年患者 ,观察用药前后肾功能指标的变化。万古霉素的用量根据血清肌酐清除率相应调整 ,按照 APACHE评分法研究影响万古霉素肾毒性的各种因素。结果 万古霉素的血药浓度不是影响其肾毒性的唯一指标 ,而 APACHE评分有助于预测万古霉素的肾毒性。高龄老年人是万古霉素肾毒性的高危人群。结论 万古霉素对于多数老年患者是安全的。但是对于 APACHE评分大于 40的危重高龄老年患者 ,其肾毒性严重 。
Objective To study the nephrotoxicity of vancomycin in the elderly patients and the factors causing it.Methods 22 cases of elderly patients with pulmonary infection and pyelonephritis were studied.All the infections were caused by pathogenic bacteria that were sensitive to vancomycin.Recording the change of renal function before and after intravenously drip of vancomycin.The dosage of vancomycin was modified by creatinine clearance rate.To evaluate the factors that influenced the vancomycin nephrotoxicity according to the APACHE method.Results The drug concentration of vancomycin was not the only factor that influenced the severity of nephrotoxicity for the elderly patients.APACHE method was useful for forecasting the nephrotoxicity of vancomycin.Very elderly patients were high risk population.Conclusions Although vancomycin was safe for most elderly patients,for those elderly patients with APACHE score more than 40,the nephrotoxicity was severe,and sometiimes developed into renal failure.
出处
《北京医学》
CAS
北大核心
2001年第5期280-282,共3页
Beijing Medical Journal
