摘要
目的探究在美罗培南持续泵入治疗重症监护病房(ICU)老年脓毒血症患者中药代动力学/药物效应动力学(PK/PD)的作用及机制。方法 2019年1月至2020年3月60例ICU老年脓毒血症患者,按照不同给药方式分为治疗药物监测(TDM)组和对照组。TDM组调整美罗培南剂量;对照组不调整剂量。比较两组治疗效果、微生物治愈率和病死率。结果 TDM组临床指标均显著低于对照组,差异有统计学意义(P <0.05)。TDM组临床治愈率(90.00%)显著高于对照组(66.67%),微生物治愈率(93.33%)显著高于对照组(70.00%),差异有统计学意义(P <0.05)。TDM组不良副作用发生率(10.00%)、病死率(3.33%)显著低于对照组(23.33%、10.00%),差异有统计学意义(P <0.05)。TDM组实现PK/PD目标的患者(93.33%)显著高于对照组(53.33%),差异有统计学意义(P <0.05)。结论 PK/PD理论可优化ICU老年脓毒血症美罗培南治疗方案,提高治疗治疗有效率和微生物治愈率、降低不良反应发生率和病死率。
Objective To explore the role and mechanism of pharmacokinetics/pharmacokinetics(PK/PD)in ICU elderly patients with sepsis.Methods Sixty elderly patients with sepsis in ICU from January 2019 to March 2020 were randomly divided into the Therapeutic Drug Monitoring(TDM)group and control group According to different methods of administration.The dose of meropenem was adjusted in TDM group.The control group was not adjusted.The treatment effect,microbial cure rate and case fatality rate were compared between the two groups.Results The clinical indexes of TDM group were significantly lower than those of control group(P<0.05).The clinical cure rate(90.00%)and microbial cure rate(93.33%)in TDM group were significantly higher than those in control group(70.00%),and the difference was statistically significant(P<0.05).The incidence of adverse side effects(10.00%)and case fatality(3.33%)in TDM group were significantly lower than those in control group(23.33%,10.00%),and the difference was statistically significant(P<0.05).The patients who achieved PK/PD goal in TDM group(93.33%)were significantly higher than those in control group(53.33%),and the difference was statistically significant(P<0.05).Conclusion PK/PD theory can optimize the treatment of meropenem in ICU elderly with sepsis,improve the effective rate of treatment and microbial cure rate,reduce the incidence of adverse reactions and mortality.
作者
安阳
童朝辉
张睢扬
王磊
谢建新
张旭燃
AN Yang;TONG Chaohui;ZHANG Suiyang;WANG Lei;XIE Jianxin;ZHANG Xuran(Department of Respiratory and Critical Care Medicine,Hebei Yanda Hospital,Langfang 065201,China;不详)
出处
《实用医学杂志》
CAS
北大核心
2021年第6期726-729,734,共5页
The Journal of Practical Medicine
基金
河北省医学科学研究重点课题(编号:20180898)。
