替考拉宁在感染的血液病患者中血药浓度的监测与应用价值分析

Monitoring and Application Value of Teicoplanin in Patients with Infectious Hematologic Diseases

目的:探讨替考拉宁在感染的血液病患者中血药浓度的监测与应用价值。方法:回顾分析2017年12月-2019年12月来我院治疗的42例革兰氏阳性球菌引起感染的血液病患者临床资料,按照临床替考拉宁的给药剂量分A组和B组,每组21例。利用高效液相色谱法(HPLC)检测患者第5天用药前30 min的血药浓度,利用酶联免疫荧光法检测患者降钙素原(PCT)水平。比较两组血药浓度,临床疗效及PCT水平的差异,并记录不良反应。结果:B组患者血药浓度(15.12±4.68)mg/L高于A组的(11.76±5.31)mg/L,且B组患者PCT水平(0.86±1.21)ng/mL低于A组的(2.23±1.63)ng/mL,差异均有统计学意义(P<0.05)。B组患者临床有效率为95.24%(20/21),A组临床有效率为71.43%(15/21),两组临床有效率比较差异有统计学意义(P<0.05)。A组发生不良反应发生率为23.81%(5/21),B组不良反应发生率为19.05%(4/21),两组患者不良反应发生率比较差异无统计学意义(P>0.05)。有效组患者血药浓度(17.21±6.64)mg/L高于无效组的(10.14±5.48)mg/L;且有效组患者PCT水平(0.65±1.31)ng/mL低于无效组的(2.63±1.87)ng/mL,差异均有统计学意义(P<0.05)。结论:对感染的血液病患者,提高替考拉宁初始负荷剂量可以达到较高的有效血药浓度,临床疗效更好,且不良反应未见增加。对感染的血液病患者进行血药浓度监测,能够一定程度上反映出临床治疗效果,具有临床参考价值。

Objective: To investigate the monitoring and application value of teicoplanin in patients with infectious hematologic diseases. Methods: The clinical data of 42 patients with hematologic diseases caused by gram positive cocci treated in our hospital from December 2017 to December 2019 were retrospectively analyzed. According to the clinical dosage of teicoplanin, the patients were divided into A group and B group, with 21 cases in each group. The plasma drug concentration was detected by high performance liquid chromatography(HPLC) 30 minutes before the 5 day of administration, and the level of procalcitonin(PCT) was detected by enzyme-linked immunofluorescence. The plasma drug concentration,clinical efficacy and PCT level of the two groups were compared,and the adverse reactions were recorded. Results: The plasma drug concentration of group B was(15.12±4.68) mg/L, which was higher than that of group A(11.76±5.31) mg/L, and the PCT level of group B was(0.86±1.21) ng/mL, which was lower than that of group A(2.23±1.63) ng/mL, the differences were statistically significant(P<0.05). The clinical effective rate of group B was 95.24%(20/21), and that of group A was 71.43%(15/21), the difference between the two groups was statistically significant(P<0.05). The incidence of adverse reactions was 23.81%(5/21) in group A and 19.05%(4/21) in group B,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). The plasma drug concentration in the effective group was(17.21±6.64) mg/L, which was higher than that in the invalid group(10.14±5.48) mg/L;and the PCT level of the effective group was(0.65±1.31) ng/ml, which was lower than that of the invalid group(2.63±1.87) ng/mL, the differences were statistically significant(P<0.05). Conclusion: For the patients with infectious hematologic diseases, increasing the initial loading dose of teicoplanin can achieve a higher effective plasma drug concentration, better clinical efficacy, and no increase in adverse reactions. Monitoring plasma drug concentration in patients with infectious hematologic diseases can reflect the clinical treatment effect to a certain extent, which has clinical reference value.