Peckman H J, Dupuis R E, Sawyer W T, Brouwer K L, Cross R E
Department of Pharmacy, University of North Carolina Hospitals, USA.
Ther Drug Monit. 1996 Dec;18(6):647-53. doi: 10.1097/00007691-199612000-00004.
A study was conducted to determine whether assay-specific quantitative differences exist in the determination of vancomycin serum concentrations obtained from patients with renal dysfunction. Vancomycin serum concentrations were obtained during the first week of therapy for each of three time intervals: 48-96 h, 96-144 h, and 144-192 h after administration of the first dose of vancomycin. Vancomycin serum concentrations were measured using the enzyme-multiplied immunoassay technique (EMIT) and fluorescence polarization immunoassay (FPIA). Twenty patients with an estimated creatinine clearance < 40 ml/min who were receiving intravenous vancomycin were evaluated. Hemodialysis was required in 16 of 20 patients. Fifty samples were included in the data analysis. The mean (+/-SD) serum concentrations obtained with EMIT and FPIA were 10.9 mg/L (+/-5.3) and 12.6 mg/L (+/-5.7), respectively (p = 0.13), and were not statistically different. A linear relationship was observed between EMIT and FPIA (EMIT = 0.89 x FPIA - 0.24; r2 = 0.93). No statistically significant differences were observed in the calculated pharmacokinetic parameters between methods. FPIA and EMIT are comparable methods in determining vancomycin serum concentrations within the first week of vancomycin therapy in patients with moderate to severe renal dysfunction.
开展了一项研究，以确定在测定肾功能不全患者的万古霉素血清浓度时，特定检测方法的定量差异是否存在。在万古霉素首次给药后的三个时间间隔的第一周内获取万古霉素血清浓度：给药后48 - 96小时、96 - 144小时和144 - 192小时。使用酶放大免疫分析技术（EMIT）和荧光偏振免疫分析（FPIA）测量万古霉素血清浓度。对20名接受静脉注射万古霉素且估计肌酐清除率<40 ml/分钟的患者进行了评估。20名患者中有16名需要进行血液透析。50个样本纳入数据分析。用EMIT和FPIA测得的平均（±标准差）血清浓度分别为10.9 mg/L（±5.3）和12.6 mg/L（±5.7）（p = 0.13），无统计学差异。观察到EMIT和FPIA之间存在线性关系（EMIT = 0.89×FPIA - 0.24；r2 = 0.93）。两种方法在计算的药代动力学参数方面未观察到统计学显著差异。在中度至重度肾功能不全患者的万古霉素治疗第一周内，FPIA和EMIT是测定万古霉素血清浓度的可比方法。
