低蛋白血症对儿童万古霉素血药浓度监测的影响分析

目的:分析低蛋白血症患儿对万古霉素血药浓度的影响,为其治疗药物监测及个体化给药提供参考。方法:收集2015年1月-2019年5月在某院就诊并进行万古霉素血药浓度监测的63例患儿的临床资料,包括年龄、性别、体质量、临床诊断、白蛋白、万古霉素浓度、用法用量、联合用药、不良反应等,并对监测值进行统计分析。结果:白蛋白正常组(占58.1%),万古霉素平均稳态谷质量浓度(6.8±7.0)mg·L^-1,低蛋白血症组(占41.9%),平均谷质量浓度(3.4±3.5)mg·L^-1,低于成人应用万古霉素推荐血药浓度标准;合并用药13例,无严重不良反应。结论:万古霉素血药浓度个体差异较大,受多种因素影响,尤其是儿童,低蛋白血症儿童进行血药浓度监测可以更好地指导个体化用药。

Analysis of the influence of blood concentration monitoring of vancomycin in children with hypoproteinemia

OBJECTIVE To analyze the effect of children with hypoproteinemia on vancomycin plasma concentration and provide reference for therapeutic drug monitoring and individualized dosing.METHODS Clinical data of 63 children with vancomycin blood concentration monitoring in our hospital from January 2015 to May 2019 were collected,including age,sex,weight,clinical diagnosis,albumin,vancomycin blood concentration,usage and dosage,combined medication and adverse drug reactions,et al,and the monitoring values were statistically analyzed.RESULTS In the normal albumin group (58.1%),the mean steady-state trough concentration of vancomycin was (6.8±7.0) mg·L^-1,and in the hypoproteinemia group (41.9%),the mean trough concentration was (3.4±3.5) mg·L^-1,which was lower than the recommended plasma concentration standard of vancomycin in adults;13 patients were treated with concomitant drugs without serious adverse reactions.CONCLUSION The plasma concentration of vancomycin varies greatly among individuals and is influenced by many factors,especially in children.The monitoring of plasma concentration in children with hypoproteinemia can better guide individualized medication.