摘要
目的:基于药物浓度监测探讨万古霉素相关儿童急性肾损伤(VA-AKI)的危险因素,为临床安全用药提供参考。方法:回顾性分析南通大学附属常州儿童医院2021年11月至2024年10月使用万古霉素并监测血药浓度的患儿病例资料,对血药浓度、人口统计学、临床资料及相关实验室检查等数据进行分析。结果:共纳入120例患儿,其中男68例,女52例,年龄12 d~13岁6个月;万古霉素用药疗程3~28 d。VA-AKI发生率为14.17%(17/120),AKI组与非AKI组通过单因素分析和多因素logistic回归分析显示,万古霉素谷浓度高和入住重症监护室(ICU)为VA-AKI的独立危险因素。不同谷浓度组AKI发生率比较结果显示,谷浓度>15μg/mL时AKI发生率最高,为60.00%;而谷浓度<5μg/mL组和5~15μg/mL组AKI发生率分别为2.94%和13.16%,且各谷浓度组间AKI发生率比较差异有统计学意义(P<0.05)。结论:万古霉素谷浓度高和入住ICU为儿童VA-AKI的独立危险因素,谷浓度>15μg/mL时,VA-AKI发生率明显升高。
Objective:To explore the risk factors for vancomycin-associated acute kidney injury(VA-AKI)in children based on drug concentration monitoring,so as to provide reference for safe clinical medication.Methods:Retrospective analysis was performed on clinical data of children received vancomycin and monitored for blood concentration in the Affiliated Changzhou Children’s Hospital of Nantong University from Nov.2021 to Oct.2024.Data of blood concentration,demography,clinical information and related laboratory tests were analyzed.Results:A total of 120 children were enrolled,including 68 males and 52 females,aged from 12 d to 13 years and 6 months.Vancomycin was administered for 3 to 28 d.The incidence of VA-AKI was 14.17%(17/120).Univariate analysis and multivariate logistic regression analysis showed that high trough concentration of vancomycin and admission of intensive care unit(ICU)were independent analysis factors for VA-AKI.Comparison of AKI incidence across different trough concentration groups showed that the highest incidence of AKI(60.00%)occurred when trough concentration>15μg/mL,which was significantly higher than the overall incidence;whereas the incidence of AKI in the groups with trough concentrations<5μg/mL and 5 to 15μg/mL was respectively 2.94% and 13.16%,both lower than the overall incidence.The differences in incidence of AKI among the trough concentration groups were statistically significant(P<0.05).Conclusion:High trough concentration of vancomycin and admission of ICU are the independent risk factors for VA-AKI in children,and the incidence of VA-AKI significantly increases when the trough concentration>15μg/mL.
作者
胡美绘
郑爱斌
李寰舟
栗金权
刘飞
张雯婷
Hu Meihui;Zheng Aibin;Li Huanzhou;Li Jinquan;Liu Fei;Zhang Wenting(Affiliated Changzhou Children’s Hospital of Nantong University,Jiangsu Changzhou213018,China;Changzhou Key Laboratory of Clinical Pharmacy,Jiangsu Changzhou 213000,China)
出处
《儿科药学杂志》
2025年第9期1-4,共4页
Journal of Pediatric Pharmacy
基金
常州市科技基础设施建设计划-常州市临床药学重点实验室项目,编号CM20223005
常州市科技局应用基础研究指导性课题,编号CJ20239036。
关键词
儿童
万古霉素
药物浓度监测
危险因素
急性肾损伤
children
vancomycin
drug concentration monitoring
risk factor
acute kidney injury
