目的 分析萬古霉素血藥濃度監(jiān)測結(jié)果及臨床應(yīng)用情況，為臨床合理用藥提供參考。方法 采用反相-高效液相色譜法測定萬古霉素血藥濃度，對萬古霉素血藥濃度監(jiān)測結(jié)果及相關(guān)用藥信息進行比較分析。結(jié)果 萬古霉素谷濃度監(jiān)測202次，平均血藥谷濃度（14.36±8.12）mg/L，濃度小于10 mg/L的有68例次（33.66%），在10～20 mg/L的有100例次（49.51%），大于20 mg/L的有34例次（16.83%）；腎功能正常與異常組間，血藥谷濃度有顯著性差異；用藥前后，各項腎功能指標(biāo)無顯著性差異。結(jié)論 萬古霉素個體差異大，需加強血藥濃度監(jiān)測；針對腎功能異常患者，臨床醫(yī)生和藥師需審慎評估給藥劑量；臨床醫(yī)生應(yīng)根據(jù)血藥濃度及時調(diào)整用藥方案，實現(xiàn)個體化給藥。

Objective To analyze the clinical application and serum concentration monitoring of vancomycin, in order to provide references for rational clinical usage. Methods Reversed phase high performance liquid chromatography was used to determine serum concentration of vancomycin by means of comparative analysis on serum concentration monitoring results and related information of drug use. Results Totally 202 cases of vancomycin serum concentration were monitored. The average trough concentration of vancomycin was (14.36±8.12) mg/L. There were 68 cases (33.66%) lower than 10 mg/L, 100 cases (49.51%) of 10-20 mg/L, and 34 cases (16.83%) over 20 mg/L. For patients with normal renal function and impaired renal function, the difference of trough concentration was statistically significant. Compared of blood urea nitrogen, serum creatinine, cystatin C and creatinine clearance before and after treatment of vancomycin, with no significant difference. Conclusion Due to the large individual difference, it is very important to strengthen serum vancomycin concentration monitoring in clinic. For patients with impaired renal function, clinicians and pharmacists should assess the dosage regimen of vancomycin cautiously. Clinicians need to modulate the dosage regimen and implement individualized medication according to vancomycin serum concentration.