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目的分析ICU患者和PICU患者万古霉素的血药浓度,以成人血药浓度为基准,为儿童患者的剂量选择提供参考。方法测定2012年11月至2013年4月于我院PICU病房治疗的49例重症感染患儿使用万古霉素后的血药浓度值,以及2010年9月至2012年11月于我院ICU病房治疗的68例重症感染患者使用万古霉素后的血药浓度值。将浓度值、年龄、肝肾功指标等资料录入数据库,进行统计学分析。结果成人患者和儿童患者万古霉素谷浓度有显著性差异(P=0.00)。进一步分析显示,成人患者中,当万古霉素谷浓度为15~20μg/mL时,其疗效最好(P=0.03);儿童患者中,当万古霉素谷浓度为10~15μg/mL时,其疗效最好(P=0.00)。结论以成人血药浓度为基准,儿童万古霉素给药剂量偏低,血药浓度偏低,应给予足量万古霉素,以使其血药浓度尽快达到有效抑菌浓度。
Objective To analyze the plasma concentration of vancomycin in ICU patients and PICU patients, and to provide reference for the dose selection of pediatric patients on the basis of adult plasma concentration. Methods The serum concentrations of vancomycin in 49 children with severe infections treated in PICU ward in our hospital from November 2012 to April 2013 were measured and compared with those in ICU wards of our hospital from September 2010 to November 2012 68 cases of severe infections treated with vancomycin plasma concentrations. The concentration, age, liver and kidney function indicators and other data entry database for statistical analysis. Results There was a significant difference in vancomycin trough concentrations between adults and children (P = 0.00). Further analysis showed that when the vancomycin trough concentration was 15 ~ 20μg / mL in adults, the effect was best (P = 0.03). In children, when vancomycin trough concentration was 10 ~ 15μg / mL, The best effect (P = 0.00). Conclusion Based on the adult plasma concentration, the vancomycin dose in children is low and the plasma concentration is low. Therefore, enough vancomycin should be given to make the plasma concentration reach the effective inhibitory concentration as soon as possible.