【摘要】：目的:評估心臟病患者的心臟功能及腎功能對萬古霉素清除率的影響。方法:對303例患者在使用了萬古霉素注射1 h后以及下一次用藥前的血清濃度進行檢測,同時檢測患者左心室射血分數(shù)(LVEF)。根據(jù)2次檢測結(jié)果計算萬古霉素的藥動學參數(shù)。結(jié)果:LVEF50%(69例)的患者以及50%≤LVEF75%的患者(108例),其萬古霉素的清除率顯著低于LVEF≥75%(126例)的患者[萬古霉素清除率分別為(2.39±0.94)和(2.78±0.98)L·h-1 vs(3.51±1.05)L·h-1 P0.001或P0.01]。萬古霉素的清除率不僅與LVEF50%(r=0.827)和50%≤LVEF75%(r=0.774)患者的肌酐清除率的估計值高度相關(guān),同時與肌酐清除率(Ccr)60 ml·min-1患者的左心室射血分數(shù)有關(guān)(r=0.645)。Logisitic回歸分析提示Ccr、LVEF和體質(zhì)量是萬古霉素清除率的重要的獨立變量(r2=0.650)。結(jié)論:萬古霉素清除率隨著LVEF和Ccr的降低而降低。提示萬古霉素清除率除受到患者腎功能影響外還受到患者心臟功能的影響,因此在臨床使用中需要參考患者的Ccr和LVEF數(shù)值來調(diào)整萬古霉素的用量。
[Abstract]:Objective: to evaluate the effects of heart function and renal function on vancomycin clearance in patients with heart disease. Methods: the serum concentrations of 303 patients were measured 1 hour after the injection of vancomycin and before the next medication. The left ventricular ejection fraction (LVEF).) was also measured. The pharmacokinetic parameters of vancomycin were calculated according to the results of two tests. Results: the clearance rate of vancomycin in LVEF50% (69 cases) and 50% 鈮，

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