目的:研究万古霉素在模型引导下精准化给药是否可以达到更佳的临床治疗效果，从而推动其在实践中广泛应用。方法:采用前瞻性队列研究，试验组为使用模型引导下的精准化给药决策万古霉素给药方案的患者，对照组为仅依据现有诊疗流程决策万古霉素给药方案的患者。匹配两组数据，对比两组患者在治疗药物监测(therapeutic drug monitoring，TDM)稳态谷浓度或稳态AUC达标比例上是否存在统计学差异，评估模型软件的应用价值。结果:根据纳入和排除标准，共计280例患者的万古霉素稳态血药浓度数据用于分析。试验最终得到，试验组达标人数10例，达标率为62。50％;对照组达标人数64例，达标率为24。24％(P=0。002)。结论:模型引导下精准化给药方案能更精准地控制患者体内万古霉素血药浓度，显著提高患者稳态谷浓度达标率。因此，建议加大对该方案的研究力度，并推动其在临床实践中广泛应用。
Clinical study on model-guided vancomycin plasma concentration monitoring
AIM:The purpose of this paper is to study whether the precise administration of vanco-mycin under the guidance of the model can achieve better clinical treatment effect by imple-menting the precise medication model in Sichuan Provincial People's Hospital,so as to promote its wide application in practice.METHODS:A prospec-tive cohort study was conducted.The experimental group was patients who used the Model-informed Precision Dosing to determine the vancomycin dos-ing regimen,and the control group was patients who only decided the vancomycin dosing regimen based on the existing diagnosis and treatment pro-cess.Two sets of data were matched to compare whether there were significant differences be-tween the two groups of patients in the TDM steady-state trough concentration or the steady-state AUC compliance ratio,and to evaluate the ap-plication value of the model software.RESULTS:Ac-cording to the inclusion and exclusion criteria,the steady-state blood concentration data of vancomy-cin in a total of 280 patients were used for analysis.The final result of the experiment was that the number of people in the experimental group was 10,and the compliance rate was 62.50％.There were 64 cases in the control group,and the compli-ance rate was 24.24％(P=0.002).CONCLUSION:The study found that the model-guided precise dos-ing regimen can more accurately control the blood concentration of vancomycin in patients,and signif-icantly improve the patient's steady-state trough concentration compliance rate.Therefore,it is rec-ommended to increase the research on the pro-gram and promote its wide application in clinical practice.
model-guided precision medicationvancomycintherapeutic drug monitoring
万方数据
维普
