235例儿童万古霉素血药浓度与不良反应分析.pdfVIP

·1200 · 实用药物与临床2013年第16卷第12期　 Practical Pharmacy And Clinical Remedies,2013,Vol.16,No.12 235例儿童万古霉素血药浓度与不良反应分析 张海霞,杨　 智,何莉梅,彭翠英,龙　 荣,祝文兵,何周康 　 　 [摘　 要]　 目的　 探讨儿童万古霉素血药浓度与不良反应的关系。 方法　 收集235 例使用万古霉素治疗 并进行血药浓度监测的患儿病例资料,统计肝肾功能损伤、听力损伤发生的例数,分析不同范围万古霉素血药浓 度与不良反应的相关性。 结果　 不良反应总发生率为16．6%。 主要发生的不良反应为肝功能损害及听力损害, 发生率分别为9．4%、6．8%,均显著高于肾功能损害发生率。 不同血药浓度病例组发生不良反应的频率、类型分 布比较差异无统计学意义。 万古霉素血药浓度水平对治疗前后肝肾功能无显著影响。 结论　 在儿童,尤其是新 生儿,应用万古霉素有较高的肝功能损害及听力损害发生率。 不同范围血药浓度与肝肾损害、听力损伤3种不良 反应无显著相关。 [关键词]　 儿童;万古霉素;血药浓度;不良反应 Analysisof vancomycin serum concentration andadverse reactionin235 children　 ZHANG Hai-xia,YANG Zhi,HE Li-mei,PENG Cui-ying,LONG Rong,ZHU Wen-bing,HE Zhou-kang(Department of Pharmacy,Hunan Children’sHospital,Changsha410007,China) 　 　 [Abstract]　 Objective　 To investigate therelationship of vancomycin serum concentration and drugadversere- action(ADR)in children. Methods　 235childrenwhoweretreatedbyvancomycinandhadserumconcentrationmoni- tor wererecruited. Thenumber ofcaseswithliver,kidneyandhearingdamageaftertreatmentwascalculated. Thecor- relationbetweenserumconcentrationandADRswasanalyzed.Results　 ThetotalincidenceofADRswas16.6%. The main ADRswereliver damage(9.4%)andhearingimpairment(6.8%),andtherate ofthem were significantlyhigher than that of kidney damage. There wasno significant difference in the ADR ratesand distribution amongthe different serum concentrations groups. Vancomycin serum concentration had no significant influence on liver and kidney func- tion.Conclusion　 Children(especially neonates)who were treated with vancomycin had relatively high rates of liver damage and hearing impairment. There was no significant correlation between vancomycin serum concentration and ADRsin children. Key words:Children;Vancomycin;Serum concentration;Adverse reaction [