摘要
目的探讨耐甲氧西林金黄色葡萄球菌(Methicillin-resistant Stphylococcus aurells,MRSA)肺部感染患者万古霉素给药剂量、血药浓度和肾功能状况。方法回顾性收集2017年1月~2019年12月南通市第一人民医院收治的MRSA肺部感染患者104例,万古霉素1.5 g/d静脉滴注患者55例为A组,万古霉素2.0 g/d静脉滴注患者49例为B组。对两组万古霉素血药谷浓度进行监测,10~20 mg/L为目标血药浓度,统计比较两组的血药浓度达标率。检测比较两组治疗前和治疗1周的临床肺部感染评分(CPIS),血肌酐(Scr)、血尿素氮(BUN)等肾功能指标水平和血清白细胞介素-6(IL-6)、血清肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)等炎症因子水平。结果两组血药浓度达标率比较差异无统计学意义(P>0.05)。与同组治疗前比较,A组和B组治疗1周的CPIS、血清炎症因子水平均降低,肾功能指标水平则升高,差异有统计学意义(P<0.05)。两组治疗1周的CPIS、血清炎症因子水平比较差异无统计学意义(P>0.05)。A组治疗1周的肾功能指标水平低于B组(P<0.05)。结论万古霉素1.5 g/d静脉滴注用于MRSA肺部感染效果良好,适当降低万古霉素浓度可减轻对肾功能不良影响。
Objective To investigate the vancomycin dose,blood drug concentration and renal function status of patients with methicillin-resistant Staphylococcus aureus(MRSA)lung infection.Methods A total of 104 patients with MRSA pulmonary infection admitted to the First People's Hospital of Nantong City from January 2017 to December 2019 were selected as the research object,and 55 patients with vancomycin 1.5 g/d intravenous infusion were included in group A,and 49 patients with with vancomycin 2.0g/d intravenous infusion were were included in group B.≥10 mg/L was the target blood drug concentration,and the blood drug concentration compliance rate of the 2 groups were statistically compared.Before and after 1 week of treatment clinical pulmonary infection scores(CPIS),blood muscle plasma(Scr),blood urea nitrogen(BUN)and other renal function indexes and serum interleukin-6(IL-6),serum tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and other inflammatory factors levels of the 2 groups were detected and compared.Results There was no statistically significant difference in the compliance rate of the injected blood drug concentration of the 2 groups(P>0.05).Compared with those of the same group before treatment,the after 1 week of treatment CPIS and serum inflammatory factors levels of group A and group B decreased,while the level of renal function index after 1 week of treatment of group A and group B increased(P<0.05).There was no significant difference in the after 1 week of treatment levels of CPIS and serum inflammatory factors between the two groups(P>0.05).The level of renal function index in group A after 1 week of treatment was lower than that in group B(P<0.05).Conclusion Intravenous infusion of vancomycin 1.5g/d for MRSA pulmonary infection has good effect,and appropriately reducing the concentration of vancomycin can reduce the adverse effects on renal function.
作者
徐勤
曹季平
周佳琦
Xu Qin;Cao Jiping;Zhou Jiaqi(Department of Pharmacy,Nantong First People's Hospital,Nantong 226001,China)
出处
《中华保健医学杂志》
2020年第6期607-609,共3页
Chinese Journal of Health Care and Medicine
基金
南通市卫生和计划生育委员会科研课题项目(WKZL2018087)。
关键词
耐甲氧西林金黄色葡萄球菌
肺部感染
万古霉素
血药浓度
肾功能
Methicillin-resistant staphylococcus aureus
Pulmonary infection
Vancomycin
Blood concentration
Renal function
