新生儿万古霉素血药谷浓度影响因素分析

目的分析影响新生儿万古霉素血药谷浓度的因素,并对影响因素的相对重要性进行计算。方法选取我院2016年1月—2017年12月使用万古霉素治疗的新生儿107例进行回顾性分析,收集给药方案、人口学、肝肾功能等变量,建立以万古霉素谷浓度值为因变量的多元线性回归模型,计算模型自变量的相对重要性。结果最终所得模型方程为:C=3.28-0.48WT+0.18Cr-1.15Tau+0.55Dose。相对重要性结果显示,给药间隔为影响谷浓度最重要的因素(相关系数贡献率:50.90%)。患儿矫正体重、血肌酐值、单次给药剂量的相关系数贡献率分别为27.00%、14.60%和7.50%。结论新生儿万古霉素谷浓度值与给药间隔、患儿矫正体重、血肌酐值、单次给药剂量有显著相关性。与延长给药间隔相比,增加单次给药剂量增加谷浓度的程度较小。血肌酐值与万古霉素谷浓度呈明显正相关性。其他潜在影响新生儿万古霉素谷浓度的因素仍有待进一步研究。

Analysis of influencing factors on the vancomycin trough concentration in neonates

Objective To analyze the influencing factors on the vancomycin trough concentration in neonates and to calculate the relative importance of influencing factors. Methods 107 neonates who received the treatment of vancomycin from January 2016 to December 2017 were included in this study. A retrospective analysis was performed to establish a multivariate linear regression model with the vancomycin serum concentration as the dependent variable. The relative importance of influencing factors was then calculated. Results The final regression model was: C=3.28–0.48WT+0.18Cr–1.15Tau+0.55Dose. The result of relative importance indicated that dosing interval was the most significant covariate (the cumulative contribution rate of correlation coefficient was 50.90%). The cumulative contribution rates of adjusted weight, serum creatinine, and dose per time were 27.00%, 14.60%, and 7.50% respectively. Conclusion The vancomycin trough concentration significantly correlated with dosing interval, adjusted weight, serum creatinine, and dose per time. Compared to dosing interval, higher dose per time increased the trough concentration in a mild manner. Serum creatinine positively correlated to the trough concentration. Further investigations were necessary to identify other potential