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| 肥胖感染患者万古霉素治疗药物监测的系统评价 |
| Systemic Review of Therapeutic Drug Monitoring of Vancomycin in Obese Patients with Infection |
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| DOI： |
| 中文关键词: 万古霉素 治疗药物监测 肥胖 系统评价 |
| 英文关键词:Vancomycin Therapeutic drug monitoring Obese Systematic review |
| 基金项目: |
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| 中文摘要: |
| 摘 要 目的:系统评价万古霉素治疗药物监测在肥胖感染患者较普通感染患者的必要性。方法：系统检索PubMed、Embase、Cochrane Library和中文数据库CNKI、WanFang、CBM，检索时限均从建库至 2014 年 1 月。纳入使用万古霉素的肥胖感染患者的临床研究。按纳入和排除标准筛选文献、提取资料、评价研究质量并进行描述性分析。结果：共纳入5篇队列研究。肥胖感染患者较普通感染患者使用万古霉素后肾毒性风险有增加趋势，1篇研究的差异有统计学意义（P<0.05）；血药浓度达标率的差异无统计学意义（P>0.05）。结论：肥胖感染患者使用万古霉素后肾毒性有增加趋势，且存在药物特殊体内过程及较大个体差异，更需通过万古霉素治疗药物监测指导给药。上述结论尚需开展高质量研究验证。 |
| 英文摘要: |
| ABSTRACT Objective:To systematic evaluate the necessity of vancomycin therapeutic drug monitoring in obese patients with infection compared with normal patients with infection.Methods: Electronic databases such as PubMed, Embase, the Cochrane library and Chinese database(CNKI, WanFang, CBM) were searched from establishment dates of databases to January 2014. The clinical studies which include obese patients with infection using vancomycin intravenously were identified. The studies were screened according to the inclusion and exclusion criteria, the data were extracted, the quality of the included studies were assessed and a descriptive analysis was conducted. Results:Five cohort studies were identified. Compared with non obese patients with infection, the tendency of vancomycin induced nephrotoxicity in obsese patients with infection was increased, and one study showed statistical difference (P<0.05); but no statistical difference in the target concentration rate of vancomycin (P>0.05).Conclusion:Obese patients with infection needed TDM more to guide the therapy of vancomycin because of the increase tendency of nephrotoxicity and special body process and individual difference. More high quality studies need to be conducted to verify this conclusion. |
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