CAJ | 학술논문

目的：评估万古霉素量表指导下用药对重症监护患者药物谷浓度及肾毒性影响。方法2011年9月～2013年12月在青海省人民医院重症监护室患者按照随机数字表法进行前瞻性随机对照试验，对照组经验用药（ n＝116），试验组量表指导下用药（ n＝117），比较2组患者的万古霉素浓度和肾毒性作用。结果试验组万古霉素用药谷浓度为15.0μg／mL及以上的患者比例高于对照组（73％vs.38％，P＝0.004）。试验组初始谷浓度在15.0～20.0μg／mL之间的患者比例提高（41％vs.19％，P＝0.008）。2组间谷浓度超过20.0μg／mL的患者比例没有统计学差异（31％vs.17％，P＝0.340）。试验组和对照组患者万古霉素引起的肾脏毒性没有差异（17％vs.16％，P＝0.953）。结论使用万古霉素量表可提高重症监护患者中万古霉素初始谷浓度≥15.0μg／mL，同时不会提高药物的肾脏毒性。
목적：평고만고매소량표지도하용약대중증감호환자약물곡농도급신독성영향。방법2011년9월～2013년12월재청해성인민의원중증감호실환자안조수궤수자표법진행전첨성수궤대조시험，대조조경험용약（ n＝116），시험조량표지도하용약（ n＝117），비교2조환자적만고매소농도화신독성작용。결과시험조만고매소용약곡농도위15.0μg／mL급이상적환자비례고우대조조（73％vs.38％，P＝0.004）。시험조초시곡농도재15.0～20.0μg／mL지간적환자비례제고（41％vs.19％，P＝0.008）。2조간곡농도초과20.0μg／mL적환자비례몰유통계학차이（31％vs.17％，P＝0.340）。시험조화대조조환자만고매소인기적신장독성몰유차이（17％vs.16％，P＝0.953）。결론사용만고매소량표가제고중증감호환자중만고매소초시곡농도≥15.0μg／mL，동시불회제고약물적신장독성。
Objective To evaluate the vancomycin trough concentration and nephrotoxicity in ICU patients with scale method.Methods The patients in ICU were evaluated from September 2011 to December 2013 in the hospital by prospective randomized controlled study.Experience using drug was applied in control group (n=116).Scale method was applied in test group (n=117), vancomycin concentration and renal toxicity were compared between two groups.Results The percentage of patients with an initial vancomycin trough concentration 15.0μg/mL or higher increased in the test group as compared with control group (73%vs 38%, P=0.004).The test group also demonstrated that an increase in the percentage of patients with initial trough concentration from 15.0 to 20.0μg/mL (41% vs.19%, P=0.008), and no statistical difference in the percentage of patients with an initial vancomycin trough concentration above 20μg/mL (31% vs.17%, P=0.340).There was no difference in nephrotoxicity in test group compared with control group (17% vs.16%, P=0.953).Conclusion Use of scale method increases the percentage of initial vancomycin trough concentrations 15.0μg/mL or higher in ICU patients and is not associated with an increased occurrence of nephrotoxicity.