CAJ | 학술논문

目的：分析万古霉素血药谷浓度与肾毒性发生率的相关性。方法检索PubMed、EMbase、Cochrane Library、中国知网、万方数据库和中国生物医学文献数据库，检索时间均为建库至2014年2月。收集万古霉素谷浓度水平与肾毒性发生率的研究数据。用Meta分析合并计算灵敏度、特异度、预测优势比等效应指标，评价谷浓度与肾毒性发生率之间的关系。结果共纳入17篇文献，累计病例2802例。当临界值分别为10，15，20 mg? L－1时，合并灵敏度分别为0．83、0．69和0．43，合并特异度分别为0．35、0．61和0．83，预测优势比分别为2．65、3．60和3．85。结论万古霉素谷浓度从10 mg? L－1上升至20 mg? L－1时，肾毒性发生率呈线性上升。
목적：분석만고매소혈약곡농도여신독성발생솔적상관성。방법검색PubMed、EMbase、Cochrane Library、중국지망、만방수거고화중국생물의학문헌수거고，검색시간균위건고지2014년2월。수집만고매소곡농도수평여신독성발생솔적연구수거。용Meta분석합병계산령민도、특이도、예측우세비등효응지표，평개곡농도여신독성발생솔지간적관계。결과공납입17편문헌，루계병례2802례。당림계치분별위10，15，20 mg? L－1시，합병령민도분별위0．83、0．69화0．43，합병특이도분별위0．35、0．61화0．83，예측우세비분별위2．65、3．60화3．85。결론만고매소곡농도종10 mg? L－1상승지20 mg? L－1시，신독성발생솔정선성상승。
Objective To evaluate the association between vancomycin trough concentrations and incidence of nephrotoxicity . Methods Pubmed, EMbase, Cochrane Library, China National Knowledge Infra-structure ( CNKI ) , WanFang Data and Chinese Bio Medical Literature Database ( CBM) were systematically searched from inception to February 2014.Specificity, sensitivity and predictive odds ratios with 95% confi-dence intervals were calculated.Results Seventeen observational stu-dies and 2802 patients were included in the Meta-analysis.While cut-offs of trough concentrations were 10 , 15 or 20 mg? L-1 , pooled sensi-tivity were 0.83, 0.69 or 0.43, pooled specificity were 0.35, 0.61 or 0.83 , pooled predictive odds ratios were 2.65 , 3.60 or 3.85. Conclusion There is definitive association between vancomycin trough concentrations ( ascending from 10 to 20 mg? L-1 ) and incidence of nephrotoxicity.Trough concentration is an appropriate parameter of thera-peutic drug monitoring of vancomycin.