摘要
目的:探讨开颅术后患者静脉注射万古霉素的血清和脑脊液药物浓度与临床疗效、安全性的关系。方法:采用回顾性研究方法,收集神经外科开颅术后静脉注射万古霉素患者的资料,分析患者万古霉素血药谷浓度、脑脊液浓度及其与临床疗效、不良反应的关系。结果:共收集42例患者,检测脑脊液和血清样本102例次,万古霉素血清谷浓度和脑脊液浓度与给药剂量间关系无统计学意义(P>0.05),脑脊液中万古霉素浓度在4~8 mg·L^(-1)范围内治疗有效的可能更大(P<0.05);万古霉素血清谷浓度在低于10 mg·L^(-1)时有效性降低(P<0.05),且万古霉素血清谷浓度与不良反应发生具有显著的正相关关系(P<0.01)。结论:万古霉素的血清、脑脊液浓度可以为临床治疗提供参考,颅内感染患者需要进行万古霉素治疗药物监测。
Objective:To investigate the drug concentrations in serum and cerebrospinal fluid of patients treated with intravenous vancomycin after craniotomy and their relationships with clinical efficacy and safety.Methods:Retraspective study was used to collect the data of patients receiving intravenous injection of vancomycin after craniotomy in neurosurgery and analyze the relationship between drug trough concentration in blood and drug concentration in cerebrospinal fluid.Results:A total of 42 patients were tested with 102 cases of cerebrospinal fluid and serum samples.There were no statistically significant relationships between vancomycin serum trough concentrations and cerebrospinal fluid concentrations and the administered doses.The concentration of vancomycin in cerebrospinal fluid within the range of 4-8 mg·L^(-1) may be more effective(P<0.05);the effectiveness was lowered with vancomycin serum trough concentration lower than 10 mg·L^(-1)(P<0.05),and vancomycin serum trough concentration was significantly associated with the occurrence of adverse reactions with positive correlation(P<0.01).Conclusion:The serum and cerebrospinal fluid concentrations of vancomycin can provide reference for clinical treatment.Patients with intracranial infection need to be monitored during vancomycin therapy.
作者
卢兆晨
李艳娇
曹雪
宋燕青
张文锐
Lu Zhaochen;Li Yanjiao;Cao Xue;Song Yanqing;Zhang Wenrui(Pharmaceutical Department,First Hospital of Jilin University,Changchun 130021,China)
出处
《中国药师》
CAS
2021年第10期1869-1872,共4页
China Pharmacist
关键词
万古霉素
血药浓度
脑脊液浓度
开颅手术
临床疗效
药品不良反应
治疗药物监测
Vancomycin
Blood drug concentration
Drug concentration in cerebrospinal fluid
Craniotomy
Clinical efficacy
Adverse drug reactions
Therapeutic drug monitoring
