摘要
目的通过监测重症感染患者替考拉宁血药谷浓度变化,为重症患者合理使用替考拉宁提供参考。方法回顾性分析2015年1月至2016年12月入住我院重症监护病房(ICU)使用并监测替考拉宁血清谷浓度的重症患者41例,分析替考拉宁血药谷浓度的分布情况、影响因素及临床疗效。结果 41例患者共计68例次替考拉宁谷浓度检测结果,其中仅30.89%(21/68)达到目标范围(10~60 mg/L),而未达标(<10 mg/L)达69.11%(47/68);多重线性回归分析显示,除肌酐清除率外(P=0.039),年龄、性别、体重、APACHE2评分、白蛋白及血肌酐对替考拉宁血药谷浓度的影响均无统计学意义(P>0.05);替考拉宁谷浓度达标者与未达标者死亡率比较差异无统计学意义(χ~2=1.066,P=0.302)。结论替考拉宁在重症患者中血药谷浓度达标率低,个体差异大,肌酐清除率对替考拉宁血药谷浓度影响较大,建议通过血药浓度监测的方法制定个体化给药方案。
Objective To provide a reference for the rational use of teicoplanin in critically ill patients by monitoring the changes in serum trough concentration of teicoplanin. Methods Forty-one critically ill patients who were admitted to intensive care unit（ ICU） in our hospital from January 2015 to December 2016 were chosen,and then the data was collected and analyzed retrospectively and the serum trough concentration was monitored. The distribution,influencing factors and clinical efficacy of serum trough concentration of teicoplanin were analyzed retrospectively. Results There were 68 results of serumn trough concentration,in which 21（ 21/68,30. 89%） reached the target range（ 10 - 60 mg/L）and 47（ 47/68,69. 11%） did not reach the target range（〈10 mg/L）. Only creatinine clearance rate was found to be correlated with serum trough concentration by multiple linear regression analysis（ P = 0. 039）,while age,gender,body weight,APACHE2,albumin and serum creatinine had no significant influence on the serum trough concentration（ P〈0. 05）. There was no significant difference in the mortality between the patients whose serum trough concentration reached the standard and those whose concentration did not（ χ^2= 1. 066,P = 0. 302）. Conclusion The rate of serum trough concentration of teicoplanin reaching standard in patients with critical illness is low with great individual variability. The creatinine clearance rate has great influence on the serum concentration of teicoplanin,and the individualized schedule of drug treatment should be made.
作者
梁培
郭晓芳
LIANG Pei;GUO Xiao-fang(Department of Pharmacy;Department of ICU, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China)
出处
《实用药物与临床》
CAS
2018年第5期553-556,共4页
Practical Pharmacy and Clinical Remedies
关键词
重症患者
替考拉宁
血药谷浓度
Critical patient
Teicoplanin
Serum trough concentration
