154例患者664次万古霉素血药浓度监测分析

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.

Therapy drug monitoring analysis on 664 cases of vancomycin in 154 patients

Objective： To guide clinical rational drug use by analyzing effective range of the trough concentration ofvancomycin. Methods： A retrospective analysis was carried out to analyze the distribution of vancomycin trough concentrationsof 154 patients （664 cases） in PLA General Hospital from January 2011 to December 2012. Results： The average troughconcentration of vancomycin was （14.18 ± 9.28） mg·L-1. A total of 204 cases （30.72%, 204/664） were in the effective range of theblood concentration. The trough concentrations in 124 cases （18.68%, 124/664） exceeded the upper limit of the effective range buthad the target blood concentration according to the recommended standard of the Infectious Diseases Society of America （IDSA）.The monitoring cases and the ratio of dosage adjustment of the patients with renal insufficiency were higher than that of the patientswith normal renal function. Conclusion： Considering the needs of personalized medication, the dosage of vancomycin should beadjusted according to the target blood concentration. The concentrations of vancomycin in patients with complicated infection couldexceed the upper limit of the current effective range if necessary.