万古霉素血药浓度监测对临床用药指导意义的分析

Analysis of the guiding significance of detection of vancomycin plasma concentration in clinical medication

目的探讨万古霉素血药浓度监测对临床使用万古霉素的指导意义。方法采用回顾性分析法,选取宣城市人民医院住院患者27例,采用高效液相色谱法检测万古霉素血药浓度。分析万古霉素血药浓度检测结果及医师对万古霉素剂量调整的反馈情况。结果约有48.15%患者经验使用万古霉素谷浓度不能达到治疗浓度;当谷浓度处于10~20μg/mL、峰浓度>20μg/mL时大部分患者疗效较好。结论肾功能正常的高龄患者仍需谨慎使用大剂量万古霉素,万古霉素血药浓度监测对其临床应用具有指导意义。

Objective To explore the guiding significance of detection of vancomycin plasma concentration in clinical medication.Methods Using retrospective analysis,27 inpatients from the people's hospital of Xuancheng city were selected and the plasma concentration of vancomycin was detected by HPLC.The test results of vancomycin plasma concentration and the feedback of doctors on vancomycin dose adjustment were analyzed.Results Trough concentration of vancomycin used empirically could not reach the treatment concentration in 48.15%of the patients.When the trough concentration was 10-20μg/mL and the peak concentration was more than 20μg/mL,most of the patients had better efficacy.Conclusion High doses of vancomycin should be used with caution in elderly patients with normal renal function.Monitoring of the plasma concentration of vancomycin has great guiding significance for its clinical application.