老年患者万古霉素高谷浓度与低谷浓度疗效及肾毒性分析

Analysis of the clinical efficacy and nephrotoxicity of vancomycin at high and low trough concentrations in elderly patients in our hospital

目的:通过回顾2015年1月-2016年7月某院老年患者使用万古霉素治疗的情况,分析其临床疗效及肾毒性。方法:将符合入选标准的90例老年患者根据血药谷浓度检测结果分为2组:低谷浓度组(5~10 mg·L^(-1))与高谷浓度组(10~20mg·L^(-1)),分析2组患者使用万古霉素的疗效及肾毒性。结果:高谷浓度组临床有效率为71.67%,低于低谷浓度组的76.67%;高谷浓度组肾毒性的发生率13.33%,高于低谷浓度组的6.67%。结论:本研究观察到针对老年患者在给予万古霉素抗感染治疗时,应将血药谷浓度控制在5~10 mg·L^(-1)较为适宜,但仍需大样本进一步研究论证。

OBJECTIVE To conduct a retrospective cohort study from January,2015 to July,2016,analyze the clinical efficacy and nephrotoxicity of vacomycin for elderly patients in our hospital.METHODS In the retrospective cohort,90 sets of trough serum concentrations were analyzed.Two groups of patients were studied successively：high trough concentration group with trough serum vancomycin concentrations of 5-10 mg·L-1,and low trough concentration group with trough serum vancomycin concentrations of 10-20 mg·L-1.RESULTS Clinical efficacy rates for infected patients were 71.67% versus 76.67%in high trough concentration group and low trough concentration group.Vancomycin related nephrotoxicity rate was significantly different for infected patients in high trough concentrations group compared with that low trough concentrations group：13.3% versus 6.67%.CONCLUSION The present work provides an evidence based study to demonstrate that the vancomycin serum trough concentration for elderly patients should be 5-10 mg·L-1.While more data are needed to validate these findings.