中国药房2026，Vol.37Issue(2)：198-203,6.DOI:10.6039/j.issn.1001-0408.2026.02.11
高原地区患者万古霉素血药浓度达标的影响因素分析及预测模型构建——一项单中心回顾性研究
Analysis of factors influencing the achievement of target vancomycin plasma concentration and construction of a predictive model in patients from high-altitude regions:a single-center retrospective study
摘要
Abstract
OBJECTIVE To analyze the influencing factors for achieving target plasma drug concentration(trough)(abbreviated as"PDC")of vancomycin in patients from high-altitude regions and establish a predictive model for PDC using single-center data,providing references for rational clinical drug use.METHODS Inpatients with vancomycin(1 g,q12 h)administered intravenously in our hospital from January 2021 to June 2024 were retrospectively included.Demographic data,liver and kidney function and hematological indexes were collected.Spearman correlation analysis was used to evaluate the correlation between vancomycin PDC and each detection index.Univariate analysis was used to evaluate the differences of each index in patients with different PDC,and the effects of different gender,body mass index,age and underlying diseases(hypertension/diabetes)on vancomycin PDC.Based on the results of correlation analysis and univariate analysis,multiple linear stepwise regression analysis was used to obtain the independent predictors of vancomycin PDC and construct the prediction model.RESULTS A total of 141 patients were included,with an overall attainment rate of 46.81%for the target PDC of vancomycin.Correlation analysis showed that the vancomycin PDC was positively correlated with age,blood urea nitrogen,uric acid(UA),serum creatinine(CRE)and β2-microglobulin(β2-MG),and negatively correlated with height,weight,creatinine clearance rate(CCR),glomerular filtration rate(GFR),alanine transaminase(ALT),hemoglobin(HGB),white blood cell count and neutrophils(P＜0.05).There were significant differences in age,CRE and other 14 indexes among different PDC groups(P＜0.05 or P＜0.01).Age and underlying diseases had significant effects on vancomycin PDC(P＜0.05 or P＜0.01).CCR,direct bilirubin(DBil),β2-MG,UA,HGB and height(standardized coefficients were-0.371,0.367,0.169,0.232,-0.140,-0.132;P＜0.05)were independent predictors of vancomycin PDC.The F value of the regression equation was 34.858(P＜0.05),the R2 was 0.610,and the adjusted R2 was 0.592.CONCLUSIONS The vancomycin PDC of patients in high-altitude regions is affected by multiple factors such as renal function,liver function and hematological indexes.CCR,HGB and height could be used to predict vancomycin PDC negatively,while DBil,β2-MG and UA could be used to predict vancomycin PDC positively.The variables of the established prediction model could explain 59.2%of the variation of vancomycin PDC.关键词
万古霉素/高原地区/血浆药物谷浓度/影响因素/预测模型Key words
vancomycin/high-altitude regions/plasma drug concentration(trough)/influencing factors/prediction model分类
医药卫生引用本文复制引用
常亚娥,赵妮,桓芝兰,许贵琴,吴雪,王亚峰..高原地区患者万古霉素血药浓度达标的影响因素分析及预测模型构建——一项单中心回顾性研究[J].中国药房,2026,37(2):198-203,6.基金项目
青海省科技计划项目(No.2025-ZJ-731) （No.2025-ZJ-731）
青海省"昆仑英才·高端创新创业领军人才"培养计划项目(No.青人才字[2021]13号) （No.青人才字[2021]13号）
