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目的:探讨万古霉素在重症肺炎患儿体内消除半衰期的影响因素。方法:测定29例重症肺炎患儿静滴万古霉素后在消除相两个时间点的血药浓度,并以此估算每位患儿万古霉素的消除半衰期t1/2(β)。进一步利用SPSS13.0软件作多元线性回归分析来考察t1/2(β)与患儿性别、年龄、身高、体质量、给药量及各生化指标之间的相关性。结果:万古霉素t1/2(β)与血清肌酐(CRE,X)及天门冬酸氨基转移酶(AST,Y)浓度呈正相关(P<0.05),与其他统计数据无显著相关性。回归方程为:t1/2(β)=0.360X+0.043Y-6.316(r=0.851,P<0.01)。结论:万古霉素在重症肺炎患儿体内的消除速率与肝、肾功能密切相关,应监测血药浓度并根据患儿的自身状况来制订个体化给药方案。
Objective: To investigate the influencing factors of elimination half-life of vancomycin in children with severe pneumonia. Methods: The plasma concentrations of vancomycin in 29 patients with severe pneumonia after intravenous drip of vancomycin at two time points were determined and the elimination half-life t1 / 2 (β) of vancomycin in each patient was estimated. Further use SPSS 13.0 software for multiple linear regression analysis to investigate the correlation between t1 / 2 (β) and children’s gender, age, height, body weight, dose and the biochemical indicators. Results: There was a significant positive correlation between vancomycin t1 / 2 (β) and serum creatinine (CRE, X) and aspartate aminotransferase (AST, Y) concentrations and no significant correlation with other statistic data. The regression equation was: t1 / 2 (β) = 0.360X + 0.043Y-6.316 (r = 0.851, P <0.01). Conclusion: Vancomycin in children with severe pneumonia, the elimination rate in vivo and liver and kidney function are closely related to the monitoring of plasma concentration should be based on the child’s own condition to develop individualized dosing regimen.