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目的 :通过对万古霉素血清谷浓度监测数据的分析,探讨谷浓度有效范围对临床合理用药的指导作用。方法 :回顾性调查我院2011年1月–2012年12月154例接受万古霉素药物治疗的患者,对664例次血清谷浓度分布情况进行分析。结果:平均血药浓度谷值(14.18±9.28)mg·L-1,处于有效浓度范围内的为204例次(30.72%),超过有效浓度上限、处于美国感染病学会(IDSA)有效目标浓度的有124例次(18.68%)。肾功能不全患者的监测例次及调整用药比例均高于肾功能正常的患者。结论:依据万古霉素的有效目标浓度值调整给药剂量,更适合个体化用药需求,对于复杂感染的患者必要时可突破当前有效浓度范围的上限。
OBJECTIVE: To analyze the monitoring data of vancomycin serum trough concentration and to explore the guiding effect of the effective range of trough concentration on clinical rational drug use. Methods: A retrospective survey of 154 patients receiving vancomycin in our hospital from January 2011 to December 2012 was conducted to analyze the distribution of 664 serum trough concentrations. Results: The mean plasma concentration (14.18 ± 9.28) mg · L-1 and 204 (30.72%) in the effective concentration range, which exceeded the upper limit of effective concentration and was at the effective target concentration of IDSA There were 124 cases (18.68%). Monitoring patients with renal insufficiency cases and adjust the proportion of medication were higher than those with normal renal function. Conclusion: Adjusting the dosage according to the effective target concentration of vancomycin is more suitable for the individualized medication requirements. If necessary, it may break the upper limit of the current effective concentration range.