目的 研究影響比阿培南臨床療效的主要因素，為臨床用藥實(shí)踐提供基礎(chǔ)。方法 回顧性分析2020年3月—2022年3月入住南京大學(xué)醫(yī)學(xué)院附屬鼓樓醫(yī)院并進(jìn)行比阿培南治療藥物監(jiān)測的患者，根據(jù)臨床結(jié)局將患者分為7 d臨床有效組（有效組）和7 d臨床無效組（無效組），結(jié)合患者藥物濃度及相關(guān)臨床數(shù)據(jù)進(jìn)行Logistic回歸分析。結(jié)果 共納入111例患者，其中有效組69例，無效組42例。Logistic分析結(jié)果顯示，影響臨床療效的因素有：比阿培南谷濃度≥1.95 μg·mL^-1［比值比（OR）＝8.78，95%置信區(qū)間（95% CI）：3.29～23.42，P＜0.001）；白蛋白（ALB）≥31.05 g·L^-1（OR＝3.77，95% CI：1.29～10.93，P＝0.015）；初始C反應(yīng)蛋白（CRP）≤57.6 mg·L^-1（OR＝4.31，95% CI：1.53～12.15，P＝0.006）。結(jié)論 比阿培南谷濃度、ALB及初始CRP水平對比阿培南的臨床療效有顯著影響，在進(jìn)行治療藥物監(jiān)測的同時需密切關(guān)注患者的基礎(chǔ)病情及感染嚴(yán)重程度，優(yōu)化臨床治療方案。

Objective To investigate the main factors influencing the clinical efficacy of biapenem, including the clinically effective biapenem trough concentration cut-off values, and to provide evidence for the optimization of dosing. Methods Retrospective analysis was performed on patients admitted to Drum Tower Hospital Affiliated to Medical School of Nanjing University from March 2020 to March 2022 who underwent therapeutic drug monitoring during treatment with biapenem. Patients were divided into 7-day clinical effective group (effective group) and 7-day clinical ineffective group (ineffective group) according to the clinical results, and logistic regression analysis was performed based on drug concentration and related clinical data. Results A total of 111 patients were included, with 69 cases in the effective group and 42 cases in the ineffective group after seven days of treatment. Logistic analysis results showed that the factors influencing the 7-day clinical efficacy were: The trough concentration of biapenem ≥ 1.95 μg·mL^-1 (OR = 8.78, 95%CI: 3.29—23.42, P < 0.001), ALB ≥ 31.05 g·L^-1 (OR = 3.77, 95%CI: 1.29—10.93, P = 0.015), initial CRP ≤ 57.6 mg·L^-1 (OR = 4.31, 95%CI: 1.53—12.15, P = 0.006). Conclusion The biapenem trough concentration, ALB and initial CRP levels were significantly associated with clinical efficacy, and it is important to closely monitor the patient's underlying condition and severity of infection while conducting therapeutic drug monitoring to optimize clinical treatment.

R978.1

國家重點(diǎn)研發(fā)計劃資助項(xiàng)目（2020YFC2008303）