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目的探讨老年患者使用万古霉素治疗过程中进行肾毒性观察及血药浓度监测的意义。方法对69例明确有金黄色葡萄球菌感染的老年住院患者予万古霉素500 mg或去甲万古霉素400 mg静滴,每8小时1次,平均疗程11 d,观察用药前后肾功能指标的变化。31例患者在药物治疗过程中监测万古霉素血药浓度,根据检查结果调整治疗方案。结果65例老年患者在应用万古霉素前后血清肌酐、血尿素氮、内生肌酐清除率的变化差异无统计学意义(P>0.05)。结论老年患者应用万古霉素大多数是安全的,根据内生肌酐清除率调整用药剂量及(或)进行血药浓度监测,进行个体化给药,可以提高该药应用的安全性和有效性。
Objective To investigate the significance of nephrotoxicity observation and plasma concentration monitoring in elderly patients treated with vancomycin. Methods A total of 69 elderly hospitalized patients with staphylococcus aureus infection were treated with either 500 mg of vancomycin or 400 mg of norvanacin intravenously once every 8 hours for an average of 11 days. The changes of renal function before and after treatment Variety. Thirty-one patients were monitored for vancomycin plasma concentration during drug treatment and the treatment regimen was adjusted according to the test results. Results There were no significant differences in serum creatinine, blood urea nitrogen and endogenous creatinine clearance in 65 senile patients before and after vancomycin administration (P> 0.05). Conclusion The elderly patients with vancomycin are mostly safe to use, according to endogenous creatinine clearance adjustment dose and / or blood concentration monitoring, individualized administration, can improve the safety and effectiveness of the drug.