萬(wàn)古霉素是治療耐甲氧西林金黃色葡萄球菌的首選藥，但在使用萬(wàn)古霉素的過(guò)程中，血藥濃度過(guò)低會(huì)導(dǎo)致治療效果不佳、過(guò)高會(huì)出現(xiàn)耳和腎毒性，且體內(nèi)代謝個(gè)體差異大，易受患者的年齡、體質(zhì)量、肝腎功能、基礎(chǔ)疾病狀態(tài)、給藥間隔時(shí)間和重癥感染等多種因素的影響。因此為了保證治療有效性和安全性，臨床常采取血藥濃度監(jiān)測(cè)來(lái)指導(dǎo)萬(wàn)古霉素個(gè)體化用藥。從萬(wàn)古霉素血藥濃度監(jiān)測(cè)與療效和不良反應(yīng)的相關(guān)性，目前常用的藥物監(jiān)測(cè)方法（包括高效液相色譜、超高效液相色譜串聯(lián)質(zhì)譜法、免疫分析法等），不同人群萬(wàn)古霉素血藥濃度的影響因素等方面進(jìn)行了歸納總結(jié)，以期為該藥的臨床合理應(yīng)用提供指導(dǎo)。

The vancomycin is the first choice for treatment of methicillin-resistant staphylococcus aureus drugs, but in the use of vancomycin in the process of blood drug concentration is too low will lead to poor treatment effect, can appear high ear and renal toxicity, and metabolic individual difference is big, vulnerable to the patient's age, body mass, liver and kidney function, basic disease states, dosing interval and the influence of many factors such as severe infection, so in order to guarantee the treatment efficacy and safety. Blood concentration monitoring is often used to guide the individualized administration of vancomycin. The correlation between vancomycin plasma concentration monitoring and efficacy and adverse reactions, the commonly used monitoring methods (including high performance liquid chromatography, ultra performance liquid chromatography tandem mass spectrometry, immunoassay, etc.), and the influencing factors of vancomycin plasma concentration in different populations were summarized, providing guidance for tclinical rational drug use of vancomycin.

R978.1

昆明市衛(wèi)生健康委員會(huì)衛(wèi)生科研課題資助項(xiàng)目（2019-13-05-001）