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目的筛选影响患者万古霉素血清谷浓度的相关因素,为临床合理用药提供参考和指导。方法选取天津市第三中心医院2015年1月-2017年1月使用万古霉素进行治疗的患者152例,采集首次给药72h后、第二次给药之前的血清,使用UHPLC法对血清谷浓度进行测定,将患者的各项参数指标进行统计后,对可能的危险因素进行筛选分析。结果万古霉素的血清谷浓度与患者的年龄、白蛋白、血肌酐、肝功能不全和用法用量存在强相关性。结论使用万古霉素的患者应根据其肾功能制订给药方案,同时,对于老年、肾功能衰退、白蛋白降低、肝功能不全的患者应对血药浓度进行及时监测。
Objective To screen the influencing factors of vancomycin serum trough concentration and provide reference and guidance for clinical rational drug use. Methods A total of 152 patients treated with vancomycin from January 2015 to January 2017 in Tianjin Third Central Hospital were enrolled. Serum before the second administration 72 hours after the first administration was collected, Concentration were measured, the parameters of the patient after the statistics, the possible risk factors for screening analysis. Results Serum trough concentrations of vancomycin were strongly correlated with age, albumin, serum creatinine, hepatic insufficiency, and usage. Conclusions Patients receiving vancomycin should formulate dosing regimens based on their renal function. In the meantime, patients should be monitored for their plasma concentrations in the elderly with impaired renal function, reduced albumin, and hepatic insufficiency.