某院接受静脉-静脉血液滤过治疗的重症患者万古霉素血药浓度的影响因素分析

摘要

目的：寻找影响接受静脉-静脉血液滤过（CVVH）治疗的患者使用万古霉素时血药谷浓度变化的因素，为其个体化给药提供依据。方法收集万古霉素血药浓度与各临床指标。采用Pearson相关分析法、单因素方差分析法寻找与万古霉素单位剂量谷浓度相关的因素。结果万古霉素单位剂量浓度与血肌酐、血尿素氮呈正相关，与肌酐清除率、单位体重CVVH置换量、CVVH持续时间呈负相关（P＜0.05）。结论肾脏与CVVH治疗对肌酐清除作用的总和可有效地衡量接受CVVH治疗的重症患者体内万古霉素的清除速率。CVVH持续时间和单位体重置换量较好地反映了CVVH治疗对万古霉素的清除作用。%Objective To find the factors that influence the serum trough concentration of vancomycin. Find out the basis for individual drug delivery. Methods Vancomycin serum trough concentration and clinical parameters were collected. Using Pearson correlation analysis, one way ANOVA to find the factors related to the concentration per g dose of vancomycin.Results Vancomycin concentration per dose has positive correlation to Ssr and BUN, and has negative correlation to CVVH displacement volumes per kg weight and CVVH duration(P<0.05).Conclusion The sum of the creatinine clearance of renal and CVVH treatment can effectively measure the clearance rate of vancomycin in critically ill patients with CVVH treatment. CVVH duration and replacement volumes per kg weight reflected vancomycin clearance of CVVH treatment.