肥胖感染患者万古霉素治疗药物监测的系统评价被引量：3

Systemic Review of Therapeutic Drug Monitoring of Vancomycin in Obese Patients with Infection

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摘要目的:系统评价万古霉素治疗药物监测在肥胖感染患者较普通感染患者的必要性。方法:系统检索Pub Med、Embase、Cochrane Library和中文数据库CNKI、Wan Fang、CBM,检索时限均从建库至2014年1月。纳入使用万古霉素的肥胖感染患者的临床研究。按纳入和排除标准筛选文献、提取资料、评价研究质量并进行描述性分析。结果:共纳入5篇队列研究。肥胖感染患者较普通感染患者使用万古霉素后肾毒性风险有增加趋势,1篇研究的差异有统计学意义(P<0.05);血药浓度达标率的差异无统计学意义(P>0.05)。结论:肥胖感染患者使用万古霉素后肾毒性有增加趋势,且存在药物特殊体内过程及较大个体差异,更需通过万古霉素治疗药物监测指导给药。上述结论尚需开展高质量研究验证。 Objective：To systematic evaluate the necessity of vancomycin therapeutic drug monitoring in obese patients with infection compared with normal patients with infection. Methods： Electronic databases such as PubMed, Embase, the Cochrane library and Chinese database（ CNKI, WanFang, CBM） were searched from establishment dates of data- bases to January 2014. The clinical studies which include obese patients with infection using vaneomycin intravenously were identified. The studies were screened according to the inclusion and exclusion criteria, the data were extracted, the quality of the included studies were assessed and a descriptive analysis was conducted. Results： Five cohort studies were identified. Compared with non-obese patients with infection, the tendency of vancomyein induced nephrotoxicity in obsese patients with infection was increased, and one study showed statistical difference （P 〈 0.05 ） ; but no statistical difference in the target concentration rate of vancomycin （ P 〉 0.05 ）. Conclusion： Obese patients with infection needed TDM more to guide the therapy of vancomycin because of the increase tendency of nephrotoxicity and special body process and individual difference. More high-quality studies need to be conducted to verify this conclusion.

作者董芊汝陈恳翟所迪

机构地区北京大学第三医院药剂科北京大学药学院药事管理与临床药学系

出处《药物流行病学杂志》 CAS 2015年第9期513-516,共4页 Chinese Journal of Pharmacoepidemiology

关键词万古霉素治疗药物监测肥胖系统评价 Vancomycin Therapeutic drug monitoring Obese Systematic review

分类号 R978.1 [医药卫生—药品]

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