目的：探讨万古霉素相关肾毒性主动监测的可行性和关键性。方法选取2010年7月至2013年7月经静脉注射万古霉素的住院患者139例，采取相关药品不良事件主动监测和评估警示体系，对提示有万古霉素阳性事件患者进行评价。结果139例患者中共有9例出现肾损害，肾功能不全代偿期、肾功能不全失代偿期、肾衰竭期、肾衰竭终末期的发生率分别是44．44％、22．22％、22．22％、11．11％。且血清肌酐在133μmol／L以上、血清肌酐较基线增加50％、血肌酐较基线增加44μmol／L的阳性预警率分别为55．56％、22．22％、22．22％，其在人工关联性评价结果中分别为19．18％、19．18％、56．54％。结论应根据患者病情等进行个体化万古霉素使用设置。%Objective To explore the feasibility and importance of active monitoring of vancomycin‐related nephrotoxicity .Meth‐ods During July 2010 to July 2013 ,a total of 139 cases of inpatients received vancomycin through intravenous injection were en‐rolled in this study .The adverse drug reaction active monitoring and early warning system were utilized to evaluate patients with vancomycin positive events .Results Among the 139 cases of patients ,there was 9 cases of patients with renal damage .The inci‐dences of compensatory stage of renal insufficiency ,decompensatory stage of renal insufficiency ,renal failure stage and end‐stage re‐nal failure were 44 .44% ,22 .22% ,22 .22% and 11 .11% respectively .The positive warning rates when serum creatinine level was above 133 μmol/L ,increased by 50% compared with the baseline ,increased with 44 μmol/L based on the baseline were 55 .56% , 22 .22% and 22 .22% respectively ,and those positive warning rates in artificial relevance evaluation were 19 .18% ,19 .18% and 56 .54% respectively .Conclusion It is necessary to individualize utilization of vancomycin according to patients′s condition .
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