CAJ | 학술논문

目的：观察万古霉素的使用对幼儿听力的影响。方法回顾分析于2014年1月至2014年6月北京儿童医院感染科收治的急性感染患儿，治疗方案中使用万古霉素的患儿22名，分别在用药前及用药后进行听力学检测，分析患儿用药前后、伴随用药、不同用药时长的听力阈值、阈值潜伏期情况；比较万古霉素近期药效对听力的影响；分析用药后肝肾功异常情况与听力学的关系。统计学方法为配对t检验或秩和检验，P＜0.05为差异有统计学意义。结果共纳入2月-59月患儿22名，中位数年龄为28月，所有患儿用药前后的听性脑干反应阈值、Ⅰ波、Ⅲ波、Ⅴ波潜伏期及Ⅰ-Ⅴ波间期变化均无统计学差异；合并用药组（13例）和非合并用药组（9例），组间听力学变化无统计学差异；依据肝肾功能结果分正常组（14例）和异常组（8例），组间听力学变化无统计学差异；依据用药时长分小于10天组（12例），大于10天组（10例），组间听力学变化无统计学差异。结论1）万古霉素中短期的使用对幼儿的听力无明显损害；2)合并用药、用药时长、伴发的肝肾功能损害没有增加听力损害的风险。
목적：관찰만고매소적사용대유인은력적영향。방법회고분석우2014년1월지2014년6월북경인동의원감염과수치적급성감염환인，치료방안중사용만고매소적환인22명，분별재용약전급용약후진행은역학검측，분석환인용약전후、반수용약、불동용약시장적은력역치、역치잠복기정황；비교만고매소근기약효대은력적영향；분석용약후간신공이상정황여은역학적관계。통계학방법위배대t검험혹질화검험，P＜0.05위차이유통계학의의。결과공납입2월-59월환인22명，중위수년령위28월，소유환인용약전후적은성뇌간반응역치、Ⅰ파、Ⅲ파、Ⅴ파잠복기급Ⅰ-Ⅴ파간기변화균무통계학차이；합병용약조（13례）화비합병용약조（9례），조간은역학변화무통계학차이；의거간신공능결과분정상조（14례）화이상조（8례），조간은역학변화무통계학차이；의거용약시장분소우10천조（12례），대우10천조（10례），조간은역학변화무통계학차이。결론1）만고매소중단기적사용대유인적은력무명현손해；2)합병용약、용약시장、반발적간신공능손해몰유증가은력손해적풍험。
Object To determine whether vancomycin affects hearing in children. Methods Twenty two children diagnosed with acute infection were treated with vancomycin at Beijing Children’s Hospital Infec-tious Disease Department from January 2014 to June 2014. Patients’hearing was tested using auditory brain-stem responses (ABR) before and after vancomycin treatment. Relations between treatment course, co-adminis-tered medications, liver and/or kidney functions and hearing results were analyzed using paired t test or rank-sum test, with P<0.05 representing statistical significance. Results In the 22 patients (aged from 2 months to 59 months with a median age of 28 months), ABR thresholds at 4 kHz, latencies of wave I, III and V and the I-V interpeak latency showed no statistically significant differences before and after vancomycin treat-ment, or when compared between those treated with (n=13) or without (n=9) additional co-administered medi-cations. Nor did hearing show statistically significant differences when compared between patients with (n=8) or without (n=14) co-existing abnormal liver and/or kidney functions. No significant difference in hearing was seen between patients treated for less than 10 days (n=12) and those treated beyond 10 days (n=10). Conclu-sion 1) The use of vancomycin has no damaging effects on hearing in young children over short term. 2) How-ever, potentially increased risks for hearing damage associated with co-administration of medications, pro-longed duration of treatment or abnormal live/kidney functions may need further studies.