【摘要】 目的:通过监测万古霉素血药浓度,分析万古霉素在感染性疾病新生儿体内消除半衰期的影响因素,为临床用药提供参考。方法:对2012年8月至2014年7月收治于湖南省郴州市第一人民医院北院(儿童医院)新生儿科和郴州市第三人民医院新生儿科的30例感染性疾病使用万古霉素的患儿进行血药浓度测定,采用药物代谢动力学一室模型估算万古霉素消除半衰期,采用多因素线性回归分析法分析患儿日龄、血肌酐水平等因素对半衰期的影响。结果:感染性疾病新生儿体内万古霉素的消除半衰期为3.07~11.7 h,平均(6.24±2.23)h,相关影响因素主要为患儿的日龄(P=0.012)和血肌酐水平(P=0.084)。结论:万古霉素在新生儿患儿体内消除较慢,影响因素多,临床用药时应监测血药浓度并据此调整治疗方案,使之更加安全有效。更多还原

【Abstract】 Objective: Through the analysis of the blood drug concentration of vancomycin,to study the influence factors of vancomycin’s elimination half-Life in the newborn,then provide reference for clinical medication. Methods: From August 2012 to July2014,the serum concentrations of vancomycin in 30 neonatal cases were determined in the First People’s Hospital of Chenzhou and the Third People’s Hospital of Chenzhou. The elimination half-life of vancomycin was estimated by pharmacokinetic principles of the one compartment model,the influencing factors were analyzed by the multivariate linear regression analysis. Results: The range of elimination half-life of vancomycin in neonates was 3. 07 ~ 11. 70 h,the average was( 6. 24 ± 2. 23) h,multiple regression analysis showed that,for vancomycin in neonates,the elimination half-life was negatively correlated with day age( P = 0. 012),and was positively correlated with serum creatinine( P = 0. 084). Conclusion: The elimination rate of vancomycin in neonates is slower than that in adults,so the serum concentration of vancomycin should be monitored in clinical medication and the dose should be adjusted in the treatment plan,to make it more safe and effective.更多还原