万古霉素血药浓度与肾功能指标间的关系

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Abstract

Objective To explore the changes of renal function when the Vancomycin at a minimum concentration (Cmin)was first detected after intravenous administration of vancomycin, and to evaluate the correlation between blood concentration of Vancomycin and renal function indicators. Methods A total of 61 patients with severe brain injury and Gram-positive cocci (G+) pneumonia hospitalized in the Neuro-Intensive Care Unit of the 904th Hospital of the PLA(formerly 101 Hospital) from January 2015 to December 2017 were selected. The biochemical indicators including blood urea nitrogen (BUN), serum creatinine (SCr), β2 microglobulin (β2-MG), α1 microglobulin (α1-MG), cystatin C(Cys-C) before Vancomycin and 48 hours after medication were tested. The estimated glomerular filtration rate (eGFR)and Vancomycin concentration were calculated using Modification of Diet in Renal Disease. Statistical analysis was performed on the renal function indicators before and after medication, and the correlation between Vancomycin plasma concentration and renal function indicators was analyzed using multiple correlation analysis and multiple linear regression analysis. Results After treatment, the levels of β2-MG and Cys-C were higher than those before treatment, and the differences were statistically significant (P＜0.05). There were no statistical differences in the levels of BUN, SCr, and α1-MG before and after treatment (P＞0.05). After treatment, the eGFR level was lower than that before treatment, and the difference was statistically significant (P＜0.05). The blood concentration of Vancomycin was positively correlated with the levels of BUN, SCr, β2-MG and Cys-C (r=0.468, 0.612, 0.733, 0.751, P＜0.05), negatively correlated with the level of eGFR (r=-0.575, P＜0.05), and not correlated with the level of α1-MG (P＞0.05). Conclusion Forty-eight hours after using Vancomycin, indicators such as β2-MG and Cys-C increases significantly and eGFR decreases, suggesting that β2-MG, Cys-C, and eGFR are early sensitive indicators. The blood concentration of Vancomycin is positively correlated with the levels of BUN, SCr, β2-MG, and Cys-C, and negatively correlated with the level of eGFR.

Key words： Vancomycin Blood concentration 2 microglobulin;Cystatin C;Estimated glomerular filtration rate')" href="#">β2 microglobulin;Cystatin C;Estimated glomerular filtration rate

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