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目的探讨万古霉素血药浓度监测的临床应用状况,为临床合理用药的指导提供依据。方法对本院2013年12月至2014年12月期间42例应用万古霉素同时愿意接受血药浓度监测的病人的血液标本进行回顾性分析,采用高效液相色谱法(HPLC)测定万古霉素血药浓度,分析观察万古霉素血药浓度值和观察用药后的疗效及相关不良反应等。结果 42例患者用药后38例患者获得临床痊愈,其痊愈率达90.48%,失败4例,失败率达10.52%;研究发现肾功能正常组及肾功能不全组的峰浓度和谷浓度均高于有效浓度范围,分别为47.37%和100%,两组的谷浓度分布相比,差异无统计学意义(P>0.05),峰浓度分布相比,差异有统计学意义(P<0.05);患者在治疗期间不良反应发生率为4.76%。结论万古霉素应用量和血药浓度值均偏低,临床医师需提高用量同时加强血药浓度监测,结合临床实际实现个体化合理给药,以保证受试者的用药安全,让药物发挥更好的作用。
Objective To investigate the clinical application status of vancomycin plasma concentration monitoring and provide the basis for the guidance of clinical rational drug use. Methods A retrospective analysis was performed on 42 blood samples from 42 patients who were treated with vancomycin and who were willing to receive blood concentration monitoring from December 2013 to December 2014 in our hospital. The blood samples of vancomycin Blood concentration, analysis and observation of vancomycin blood concentration and observe the efficacy of the drug and related adverse reactions. Results In 42 patients, 38 patients achieved clinical recovery after cure, the cure rate reached 90.48%, failure in 4 cases, the failure rate was 10.52%. The study found that the renal function in normal group and renal dysfunction group peak concentration and trough concentration were higher than The effective concentration range was 47.37% and 100%, respectively. There was no significant difference in trough concentration distribution between the two groups (P> 0.05), and the peak concentration distribution was statistically significant (P <0.05) The incidence of adverse reactions during treatment was 4.76%. Conclusion Vancomycin levels and plasma concentration are low, clinicians need to increase the amount of blood concentration monitoring while strengthening the monitoring, combined with clinical practice to achieve individual rational administration, in order to ensure the subjects medication safety, so that drugs play more Good effect.