陈海燕

呼和浩特市第二医院药剂科，内蒙古呼和浩特010031

万古霉素治疗耐甲氧西林金黄色葡萄球菌的疗效和血药浓度分析

陈海燕

呼和浩特市第二医院药剂科，内蒙古呼和浩特010031

目的分析万古霉素治疗耐甲氧西林金黄色葡萄球菌（MRSA）的疗效和血药浓度。方法选择我院2013年5月～2014年5月收治的50例耐甲氧西林金黄色葡萄球菌感染患者，全部患者均接受万古霉素治疗，根据血药谷浓度分析结果，分为甲组（＜5 μg/mL）、乙组（5～10 μg/mL）、丙组（＞10 μg/mL），观察患者的临床疗效。结果0.5 g/次剂量，3次/d使用者多，血药谷浓度多为5～10 μg/mL；MRSA对万古霉素敏感率为100.00%；三组患者治疗总有效率、细菌清除率比较，差异有统计学意义（P＜0.05）；治疗后所有患者炎症反应指标水平低于治疗前，差异有统计学意义（P＜0.05）。结论万古霉素对耐甲氧西林金黄色葡萄球菌感染患者有良好的治疗效果，随着血药浓度的增加，可提高细菌清除率和治疗有效率，值得临床推广。

耐甲氧西林金黄色葡萄球菌曰感染曰万古霉素曰血药浓度

[Abstract]Objective To observe the curative effects and blood concentration of vancomycin in the treatment of meticillin-resistnat staphylococcus aureus（MRSA）.Methods 50 patients infected with MRSA who were admitted to our hospital from May 2013 to May 2014 were selected.All the patients were given vancomycin.According to the analysis results of trough blood concentration，the patients were assigned to the group A（＜5 μg/mL），group B（5-10 μg/mL）and group C（＞10 μg/mL），and the clinical curative effects of the patients were discussed.Results There were more patients receiving 0.5 g/time for 3 times/d，and the trough blood concentration was 5-10 μg/mL for most patients；the sensitivity of MRSA towards vancomycin was 100%；the differences of treatment effective rate and bacterial clearance rate were significant（P＜0.05）；the indicator level of inflammatory responses after the treatment was lower than that before the treatment（P＜0.05）.Conclusion For the patients infected with MRSA，vancomycin has favorable curative effects.With the increase of blood concentration，vancomycin is able to improve bacterial clearance rate and treatment effective rate，which is worthy of promotion and application.

[Key words]Meticillin-resistnat staphylococcus aureus（MRSA）；Infection；Vancomycin；Blood concentration

耐甲氧西林金黄色葡萄球菌（MRSA）是医院感染的重要病原菌，其感染率呈逐年上升趋势，MRSA对多种抗菌药物具有耐药性，其所致的感染易流行或暴发流行，治疗难度和风险较大，死亡率较高，引起了国内外医学界的高度重视。万古霉素是一种糖肽类抗菌药物，对革兰阳性菌具有较强的杀灭作用，是治疗耐甲氧西林金黄色葡萄球菌感染的常见药物，药物剂量、使用频率不同，所获得的治疗效果存在差异［1］。在治疗过程中，应密切监测万古霉素血药浓度，制定个性化治疗方案，以实现令人满意的治疗效果［2］。……