万古霉素群体药代动力学模型系统研究

Systematic research of vancomycin population pharmacokinetic models

目的系统检索评价万古霉素群体药代动力学(PPK)模型的研究现状,为临床上药师对万古霉素进行剂量调整及后续万古霉素PPK研究提供参考。方法检索Pub Med、Em Base、中国知网和中国生物医学文献服务系统数据库中自建库至2018年12月万古霉素PPK模型相关研究,并且按照不同患者人群进行亚组分析。结果共检索得到373篇文献,最终纳入PPK模型100个,共有47个成人患者模型,45个儿科患者模型,6个老年患者模型及2个成人和儿童混合人群模型。肌酸酐清除率和体重被普遍认为是影响万古霉素清除率和表观分布容积的重要协变量。结论目前成人及儿科患者的万古霉素PPK模型研究已经比较成熟,但是针对一些特殊人群的模型还较少,尤其是国内的研究,因此完善特殊人群的研究可进一步指导临床万古霉素个体化给药。

Objective(PPK)models of vancomycin,and therefore to provide reference for vancomycin individual dosage optimization.Methods search from the earliest available date to December 2018 was performed in PubMed,EmBase,CNKI and SinoMed databases for researches related to vancomycin population pharmacokinetics,and the researches were analyzed according to different populations.Results A total of 373 articles were initially selected and 100 models were included in this review.Among the 100 published models,47 were described in adults,45 in pediatric patients,6 in geriatric patients and 2 in adult and pediatric mixed patients.Creatinine clearance and weight were considered to be the factors that could significantly influence clearance and distribution of volume of vancomycin.Conclusion Nowadays the research of vancomycin PPK models in adults and pediatric patients is relatively enough,but models in special populations are few,especially domestic research.Therefore,improving the research of special population will be benefit to vancomycin individualized therapy.