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| 万古霉素血药峰浓度与临床结局相关性的系统评价 |
| Association Between Vancomycin Serum Peak Concentrations and Clinical Outcomes: A Systematic Review |
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| DOI： |
| 中文关键词: 万古霉素 峰浓度 临床结局 系统评价 |
| 英文关键词:Vancomycin Serum peak concentration Clinical outcomes Systematic review |
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| 中文摘要: |
| 摘 要 目的:循证评价万古霉素血药峰浓度与临床结局的相关性。方法：系统检索英文数据库（PubMed、Embase、the Cochrane Library）和中文数据库（CNKI、WanFang、CBM），获取公开发表关于万古霉素血药峰浓度和临床结局相关性的研究，对纳入研究进行描述性分析。结果：纳入6篇观察性研究，共971例患者。4篇研究评价万古霉素血药峰浓度与临床疗效的关系（有2篇按临界值分组），其中仅1篇研究显示峰浓度＞25 mg·L-1时可显著提高临床疗效，其余研究均显示血药峰浓度高低与临床疗效无相关性；4篇研究评价血药峰浓度和肾毒性的关系（2篇按临界值分组），3篇研究显示两组患者血药峰浓度高低与肾毒性无相关性。结论：现有证据无法支持万古霉素血药峰浓度与临床结局之间具有确定的相关性。 |
| 英文摘要: |
| ABSTRACT Objective:To evaluate the possible association between vancomycin serum peak concentrations and clinical outcomes through evidence based methods. Methods: Medline, Embase, Web of Sciences, the Cochrane Library and two Chinese literature databases (CNKI, CBM) were systematically searched. Randomized controlled studies and observational studies that focused on the association between vancomycin serum peak concentrations and its clinical effectiveness and safety were included. Meta analysis was conducted if studies were able to be combined. Results:Six cohort studies were included in the systematic review, including a total of 971 patients. Four studies reported effectiveness outcomes, two of which were stratified by peak levels. Only one study showed that clinical outcomes was more effective when a peak concentration higher than 25 mg·L-1, while others showed no significant correlation between peak levels and clinical outcomes. Four studies reported nephrotoxicity incidence. The nephrotoxicity incidence showed no correlation with peak levels.Conclusion:Currently evidence did not support the association between vancomycin serum peak concentrations and clinical outcomes. |
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