目的 评估万古霉素药物浓度监测(TDM)治疗严重脓毒症的临床应用效果。方法 收集2018-06至2021-12内蒙古自治区人民医院ICU收治的脓毒症患者为研究对象。按是否应用TDM分为TDM组和非TDM组。计录两组患者治疗后白细胞计数、降钙素原、C反应蛋白、中性粒细胞率、血清肌酐、住院时间和万古霉素持续使用时间,评估两组的临床疗效。结果 两组患者治疗后,白细胞计数、降钙素原、C反应蛋白、中性粒细胞率、住院时间、万古霉素使用时间对比,差异均无统计学意义。但TDM组血清肌酐(139.99±84.80) μmol/L、中性粒细胞率(79.94±7.89)%和降钙素原(3.72±5.73) ng/ml的平均值明显低于非TDM组,差异有统计学意义(P< 0.05)。结论 万古霉素TDM在对严重脓毒症患者的治疗中具有较好的指导作用,维持了有效的药物浓度,又可降低肾毒性发生风险,建议临床推广。
Abstract
Objective To access the therapeutic drug monitoring (TDM) of vancomycin in the treatment of severe sepsis. Methods Patients with sepsis admitted to ICU of People's Hospital of Inner Mongolia Autonomous Region from June 2018 to December 2021 were collected as research objects. They were divided into TDM group and non-TDM group according to whether or not TDM was applied. The white blood cell count, procalcitonin, C-reactive protein, neutrophil rate, serum creatinine, length of hospital stay and duration of vancomycin in the two groups after treatment were recorded to evaluate the clinical efficacy of the two groups. Results After treatment, there were no significant differences in WBC count, procalcitonin, C-reactive protein, neutrophil rate, hospital stay and vancomycin use time between the two groups. However, the mean values of serum creatinine (139.99±84.80) μmol/L, neutrophil rate (79.94±7.89) % and procalcitonin (3.72±5.73) ng/ml in TDM group were significantly lower than those in non-TDM group, with statistical significance (P<0.05). Conclusions TDM of vancomycin has a good guiding effect in the treatment of patients with severe sepsis, maintaining an effective drug concentration and reducing the risk of renal toxicity.
关键词
药物浓度监测 /
万古霉素 /
严重脓毒症 /
临床疗效
Key words
therapeutic drug monitoring /
vancomycin /
severe sepsis /
clinical effect
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