重症感染患者替考拉宁药物浓度监测的临床意义探讨

摘要

Objective To investigate the clinical significance of therapeutic drug monitoring of teicoplanin. Methods The clinical data of severe infection patients treated with teicoplanin in the first affiliated hospital of Xi'an Jiaotong University from Apr. 16, 2008 to Sep. 25, 2011, were retrospectively analyzed. A total of 30 patients were divided into 2 groups: MID=533.33mg/d, MID<533.33mg/d. The trough concentration of teicoplanin was measured by HPLC. Results The serum trough concentration of teicoplanin is closely related to initial dose, Pearson correlation is 0.678 and the correlation is significant at the 0.01 level(2-tailed). The Cmin and the therapeutic effect of patients who were accepted the initial load dose were higher and better than the patients who weren't accepted the initial load dose. There is no statistically difference in two teams with the side-effect of teicoplanin. Conclusion These findings suggest that a regular initial dose of teicoplanin make it possible to rapidly attain an optimal trough concentration and acquire a good therapeutic effect. It is necessary for severe infection patients treated with teicoplanin to monitor drug therapeutic concentration..%目的 探讨重症感染患者进行替考拉宁药物浓度监测的临床意义.方法 对30例重症感染患者的临床资料进行回顾性分析,根据替考拉宁治疗前3d平均起始给药剂量(MID)的不同,分为MID=533.33mg/d组和MID＜533.33mg/d组,所有患者治疗期间采集血样,应用高效液相色谱法测量血药谷浓度.结果 替考拉宁Cin水平与MID密切相关,Pearson相关性为0.678,双侧显著性检验均为0.01,使用起始负荷剂量的患者Cmin明显高于不采用起始负荷量的患者(P＜0.01),且治疗效果亦明显好于不予以起始负荷量的患者(P＜0.01),两组患者的药物不良反应发生率无明显统计学差异.结论 重症感染患者在使用替考拉宁时需要予以规范的负荷给药方式,以期快速达到有效药物治疗浓度,同时应予以治疗药物浓度监测,协助调整给药剂量,避免药物不良反应的发生.