某三级甲等医院住院患者万古霉素血药浓度监测结果与疗效关系分析

目的：了解万古霉素血药浓度监测的临床应用情况,以指导临床合理用药。方法：对某三级甲等医院2010年9月—2012年9月使用万古霉素住院患者进行的118例次血药浓度监测结果进行回顾性分析。结果：该院住院患者使用万古霉素的总有效率为70.21%（33/47）;118次万古霉素血药浓度监测所得谷浓度在治疗窗范围内的仅占30.6%（19/62）;谷浓度低于10 mg/L的占69.4%（43/62）;谷浓度〉10 mg/L的患者肾毒性发生率为8.5%（4/47）。结论：该院住院患者万古霉素用量和血药浓度均偏低,需重视其血药浓度监测并结合临床实际,实现个体化给药。

Analysis of Relationship between Blood Concentration Monitoring Results of Vancomycin and Its Curative Efficacy in A Three-A Level Hospital

OBJECTIVE：To investigate the clinical application of blood concentration monitoring of vancomycin so as to guide clinical rational use of drug. METHODS： The results of blood concentration monitoring of 118 cases treated with vancomycin from Sep. 2010 to Sept. 2012 in a three-A hospital were analyzed retrospectively. RESULTS： The total effective rate of vancomycin in this hospital was 70. 21% （33/47）. The trouzh concentrations of vaneomycin in only 30. 6% （19/62） were found to be within the therapeutic window, as against lower than 10 mg/L in 69. 4% （43/62）. In 8. 5% （4/47） of those whose trough concentrations of 〉 10 mg/L presented with renal toxicity. CONCLUSION： The dosage and blood concentration of vancomyein in this hospital were on the lower side. It is important to attach importance to blood concentration monitoring of vancomycin to achieve individualized therapy based on clinical practicality.