目的 对上海市某三甲医院应用万古霉素的儿童住院患者血药浓度监测结果进行分析,促进临床个体化用药.方法 收集2015年12月至2016年12月上海交通大学医学院附属新华医院52例使用万古霉素进行抗感染治疗的患儿的病历资料,回顾性分析万古霉素血药浓度监测结果,并在不同年龄段、不同性别之间作比较.结果 52例患儿的万古霉素峰浓度平均值为(19±9) mg/L,峰浓度范围为5.15 ～47.56 mg/L;万古霉素谷浓度平均值为(10±8)mg/L,谷浓度范围为1.97 ～ 38.03 mg/L.不同年龄段患儿万古霉素血药浓度监测结果比较,≤1个月组(19例)及＞3岁(12例)组患儿的有效血药浓度谷浓度明显高于＞1 ～3岁组(14例)[(13±9)、(12±10) mg/L比(6±3)rmg/L],差异均有统计学意义(均P＜0.05);≤1个月组的有效血药浓度峰浓度明显高于＞1 ～3岁组[(24±10) mg/L比(15±6) mg/L](P＜0.05),其余各组之间峰浓度比较,差异均无统计学意义(均P＞0.05).不同性别患儿万古霉素血药浓度监测结果比较,峰浓度和谷浓度差异均无统计学意义(均P＞0.05).结论 ≤1个月和＞3岁患儿的有效血药浓度较高.应及时监测患儿万古霉素血药浓度,临床根据结果积极调整用药.%Objective To analyze blood concentration of vancomycin in young inpatients and to promote individual administration of vancomycin.Methods Clinical data of 52 children who were treated with vancomycin in Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from December 2015 to December 2016 were reviewed.Blood concentration of vancomycin monitoring results were analyzed among different age and gender groups.Results Among 52 children,the mean maximum concentration of vancomycin was (19 ± 9)mg/L,ranged from 5.15 to 47.56 mg/L;the mean minimum concentration of vancomycin was (10 ±8) mg/L,ranged from 1.97 to 38.03 mg/L.The minimum concentration of vancomycin in ≤1 month old group(n =19) and ＞3 years old group(n =12) was significantly higher than that in ＞ 1-3 years old group (n =14) [(13 ± 9),(12 ± 10) mg/L vs(6 ± 3)mg/L] (P ＜ 0.05).The maximum concentration of vancomycin in ≤ 1 month old group was significantly higher than that in ＞ 1-3 years old group [(24 ± 10) mg/L vs (15 ± 6) mg/L] (P ＜ 0.05).Blood concentration of vancomycin showed no significant difference between males and females (P ＞ 0.05).Conclusions Blood concentration of vancomycin in children under 1 month old and over 3 years old are significantly higher than that in other age groups.Blood concentration of vancomycin in children should be closely monitored in clinical practice.
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