摘要
目的监测老年患者替考拉宁谷浓度(cmin)水平及达标情况,并探讨老年患者cmin达标的影响因素,为老年患者合理使用替考拉宁提供参考。方法回顾性收集2017年11月至2022年7月使用替考拉宁治疗的老年感染患者。分析老年患者替考拉宁cmin的分布情况。将患者性别、年龄、身高、体质量、初始负荷剂量、血清白蛋白(ALB)、尿素、肌酐清除率(Ccr)、胱抑素C、谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、总胆红素(TBIL)和急性生理与慢性健康评分(APACHE)Ⅱ评分纳入单因素和多重线性回归分析,探讨影响替考拉宁cmin达标的相关因素。结果83例老年患者监测替考拉宁cmin共129例次,cmin为(17.76±9.59)mg·L^(-1),其中88例次(占68.22%)达到目标浓度(10~30 mg·L^(-1)),26例次(占20.16%)未达标(<10 mg·L^(-1)),15例次(占11.63%)超标(>30 mg·L^(-1))。多重线性回归分析结果显示,性别(B=-3.130,95%CI=-6.219~-0.042,P<0.05),初始负荷给药剂量(B=31.251,95%CI=23.868~38.634,P<0.01),Ccr(B=-0.064,95%CI=-0.105~-0.023,P<0.01),以及总胆红素(B=-0.045,95%CI=-0.081~-0.009,P<0.05)是影响老年患者替考拉宁cmin的主要相关因素。结论老年患者替考拉宁cmin个体差异大,在优化替考拉宁给药方案时应考虑初始负荷给药剂量、Ccr和总胆红素水平因素的影响。
AIM To explore the influencing factors of achieving target teicoplanin trough concentrations(c_(min))in elderly patients by monitoring their c_(min)levels,providing reference for the rational use of teicoplanin in elderly patients.METHODS A retrospective analysis was performed on elderly patients who were treated with teicoplanin,and serum concentration of teicoplanin was monitored from November 2017 to July 2022.The distribution of teicoplanin c_(min)in elderly patients were collected.Various patient parameters were incorporated into both univariate and multivariate linear regression analyses to explore the related factors affecting the standard of teicoplanin c_(min).The parameters included the patient's gender,age,height,body weight,initial loading dose of teicoplanin,serum albumin(ALB)levels,urea levels,creatinine clearance rate(Ccr),cystatin C levels,alanine aminotransferase(ALT)levels,aspartate aminotransferase(AST)levels,gamma-glutamyl transferase(GGT)levels,alkaline phosphatase(ALP)levels,total bilirubin(TBIL)levels,Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score.RESULTS A total of 129 samples of teicoplanin c_(min)in 83 elderly patients were enrolled,and it was found that 88 samples(68.22%)reached the target concentration(10-30mg·L^(-1)),26 samples(20.16%)<10 mg·L^(-1)and 15 samples(11.63%)>30 mg·L^(-1).Multiple linear regression analysis revealed that gender(B=-3.130,95%CI=-6.219--0.042,P<0.05),the initial loading dosage of teicoplanin(B=31.251,95%CI=23.868-38.634,P<0.01),Ccr(B=-0.064,95%CI=-0.105--0.023,P<0.01),and the level of TBIL(B=-0.045,95%CI=-0.08--0.009,P<0.05)were correlated with the teicoplanin c_(min)in elderly patients.CONCLUSION The individual difference of teicoplanin c_(min)in elderly patients is large,and the influence of initial loading dose,Ccr and total bilirubin level should be considered when optimizing the dosage regimen of teicoplanin.
作者
岑菁
高倩
刘睿翔
马攀
CEN Jing;GAO Qian;LIU Ruixiang;MA Pan(Department of Pharmacy,The First Affiliated Hospital of Army Medical University,Chongqing 400038,China)
出处
《中国临床药学杂志》
CAS
2024年第8期615-619,共5页
Chinese Journal of Clinical Pharmacy
基金
重庆市科卫联合医学科研项目(编号2023QNXM031)。
关键词
替考拉宁
老年患者
谷浓度
负荷剂量
肌酐清除率
影响因素
teicoplanin
elderly patient
serum trough concentration
loading dose
creatinine clearance rate
influencefactor
