本文關(guān)鍵詞：萬古霉素血藥谷濃度和臨床結(jié)局相關(guān)性的系統(tǒng)評(píng)價(jià)和Meta分析（英文）　出處：《藥物流行病學(xué)雜志》2016年04期 　論文類型：期刊論文

  更多相關(guān)文章： 萬古霉素 谷濃度 死亡率 治療失敗率 腎毒性

【摘要】：目的:研究萬古霉素血藥谷濃度與死亡率、治療失敗率和腎毒性之間的關(guān)系。方法:系統(tǒng)檢索Pub Med、Embase、Cochrane圖書館和三個(gè)中文數(shù)據(jù)庫(CNKI、CBM和萬方數(shù)據(jù)),檢索時(shí)間范圍均為建庫到2014年1月16日。納入所有研究萬古霉素谷濃度與臨床結(jié)局相關(guān)性的文章,由兩位研究者獨(dú)立提取數(shù)據(jù),并采用Newcastle-Ottawa評(píng)分評(píng)價(jià)觀察性研究的質(zhì)量,二分類變量結(jié)果選用相對危險(xiǎn)比(RRs)和95%可信區(qū)間(95%CI)表示,如無統(tǒng)計(jì)學(xué)異質(zhì)性則采用固定效應(yīng)模型。主要終點(diǎn)結(jié)局是死亡率和治療失敗率,次要終點(diǎn)結(jié)局是腎毒性。結(jié)果:共納入40個(gè)隊(duì)列研究。與萬古霉素谷濃度15 mg·L~(-1)的患者相比,谷濃度≥15 mg·L~(-1)的患者的治療失敗率更低(RR=0.83,95%CI:0.70~0.97,P=0.02),腎毒性發(fā)生率更高(RR=1.99,95%CI:1.56~2.53,P0.000 01);與萬古霉素谷濃度10 mg·L~(-1)或20 mg·L~(-1)相比,萬古霉素谷濃度≥10 mg·L~(-1)或≥20 mg·L~(-1)與腎毒性發(fā)生率增加明顯相關(guān);萬古霉素谷濃度與死亡率不相關(guān)。結(jié)論:與萬古霉素谷濃度15 mg·L~(-1)相比,萬古霉素谷濃度≥15 mg·L~(-1)與降低治療失敗率和腎毒性發(fā)生率增加明顯相關(guān)。當(dāng)患者的萬古霉素谷濃度≥15 mg·L~(-1)時(shí),應(yīng)注意患者增加的腎毒性發(fā)生風(fēng)險(xiǎn)。
[Abstract]:Objective: to study the relationship between serum vancomycin concentration and mortality, failure rate of treatment and nephrotoxicity. Cochrane Library and three Chinese databases, CNKI, CBM and Wanfang data. The retrieval time range was from the establishment of the database to January 16th 2014. All articles on the correlation between vancomycin valley concentration and clinical outcome were included, and the data were extracted independently by two researchers. The Newcastle-Ottawa score was used to evaluate the quality of the observational study. The relative risk ratio (RRs) and the 95% confidence interval (95 CI) were used to indicate the results of the two classification variables. If there is no statistical heterogeneity, the fixed effect model is used. The main endpoints are mortality and treatment failure rate. Secondary endpoints were nephrotoxicity. Results: a total of 40 cohort studies were conducted, compared with patients with vancomycin valley concentration of 15 mg 路L ~ (-1). The failure rate of patients with valley concentration 鈮，

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