去甲万古霉素血药浓度监测和临床用药的相关性分析

Analysis of Correlation Between Serum Concentrations of Norvancomycin and Rational Use of Drug

目的:分析重症感染患者血药浓度监测与临床用药的相关性,为临床合理使用抗菌药物提供依据。方法:采用HPLC测定去甲万古霉素血药浓度,结合临床病例、病原学检查及肾功能指标等情况,对2008年2月—2009年12月212例重症感染患者血药浓度监测结果进行统计分析。结果:患者性别与血药浓度均无明显的相关性(P≥0.05),而年龄与患者的肾功能、血药浓度均有明显的相关性(P<0.05)。结论:去甲万古霉素血药浓度监测有重要的临床意义,老年患者与肾功能不全患者更需要治疗药物监测(TDM),并适当增加监测次数来实现给药个体化。

Objective：To analyze the correlation between serum concentrations of norvancomycin and clinical rational use of drug.Methods：Serum norvancomycin concentrations were measured in 212 patients with severe infection by HPLC.The pathogenic examination,indexes of renal function,as well as combined use of drugs were also reviewed.The clinical data of 212 severe infection cases admitted to our hospital during Feb.2008 to Dec.2009 were collected and analyzed retrospectively.Results：These showed that there was no correlation between gender and serum norvancomycin concentrations （P≥0.05）,but the ages and indexes of renal function showed a strong correlation with serum norvancomycin concentrations （P 0.05）.Conclusion：The serum norvancomycin concentrations were affected by many elements in which ages and renal function of patients were manifesting factors.The renal insufficient patients or older patients should increase the frequency of TDM properly to conduct individualized medication.