Analysis of factors influencing the achievement of target vancomycin plasma concentration and construction of a predictive model in patients from high-altitude regions： a single-center retrospective study

CHANG Ya’e; ZHAO NI; HUAN Zhilan; XU Guiqin; WU Xue; WANG Yafeng

doi:10.6039/j.issn.1001-0408.2026.02.11

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Analysis of factors influencing the achievement of target vancomycin plasma concentration and construction of a predictive model in patients from high-altitude regions： a single-center retrospective study

更新时间：2026-02-10

- Analysis of factors influencing the achievement of target vancomycin plasma concentration and construction of a predictive model in patients from high-altitude regions： a single-center retrospective study
- ZHONGGUO YAOFANG Vol. 37, Issue 2, Pages: 198-203(2026)
- 作者机构：
  
  青海省人民医院药学部，西宁　810007
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2026.02.11
  CLC： R969.1;R978.1
- Received：18 August 2025，
  
  Revised：2025-12-11，
  
  Accepted：11 December 2025，
  
  Published：30 January 2026
- 稿件说明：
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常亚娥,赵妮,桓芝兰,等.高原地区患者万古霉素血药浓度达标的影响因素分析及预测模型构建——一项单中心回顾性研究[J].中国药房,2026,37(02):198-203.

CHANG Ya’e,ZHAO NI,HUAN Zhilan,et al.Analysis of factors influencing the achievement of target vancomycin plasma concentration and construction of a predictive model in patients from high-altitude regions： a single-center retrospective study[J].ZHONGGUO YAOFANG,2026,37(02):198-203.
常亚娥,赵妮,桓芝兰,等.高原地区患者万古霉素血药浓度达标的影响因素分析及预测模型构建——一项单中心回顾性研究[J].中国药房,2026,37(02):198-203. DOI： 10.6039/j.issn.1001-0408.2026.02.11.

CHANG Ya’e,ZHAO NI,HUAN Zhilan,et al.Analysis of factors influencing the achievement of target vancomycin plasma concentration and construction of a predictive model in patients from high-altitude regions： a single-center retrospective study[J].ZHONGGUO YAOFANG,2026,37(02):198-203. DOI： 10.6039/j.issn.1001-0408.2026.02.11.

摘要

目的

基于单中心数据，分析高原地区患者万古霉素血浆药物谷浓度（简称“PDC”）达标的影响因素，并建立PDC预测模型，为临床合理用药提供参考。

方法

回顾性纳入2021年1月－2024年6月于青海省人民医院接受万古霉素（1 g，q12 h）静脉注射治疗的住院患者，收集其人口学资料和肝肾功能、血液学等指标。采用Spearman相关性分析评价万古霉素PDC与各指标的相关性。采用单因素分析评估不同PDC患者各指标的差异，以及不同性别、体重指数、年龄和有无基础疾病（高血压/糖尿病）对万古霉素PDC的影响。基于相关性分析和单因素分析结果，采用多元线性逐步回归分析获取万古霉素PDC的独立预测因子并构建预测模型。

结果

共纳入141例患者，万古霉素PDC总达标率为46.81%。万古霉素PDC与患者年龄、尿素氮、尿酸（UA）、血肌酐（CRE）、β

微球蛋白（β

-MG）呈正相关，与身高、体重、肌酐清除率（CCR）、肾小球滤过率（GFR）、丙氨酸转氨酶（ALT）、血红蛋白（HGB）、白细胞计数、中性粒细胞呈负相关（

＜0.05）；不同PDC组患者的年龄、CRE等14项指标比较，差异均有统计学意义（

＜0.05或

＜0.01）；年龄、有无基础疾病对万古霉素PDC有显著影响（

＜0.05或

＜0.01）；CCR、直接胆红素（DBil）、β

-MG、UA、HGB、身高（标准化系数分别为－0.371、0.367、0.169、0.232、－0.140、－0.132，

＜0.05）是万古霉素PDC的独立预测因子；所建回归方程的

值为34.858（

＜0.05），

为0.610，调整

为0.592。

结论

高原地区患者的万古霉素PDC受肾功能、肝功能及血液学指标等多因素协同影响，其中CCR、HGB、身高可用于负向预测患者万古霉素PDC，而DBil、β

-MG、UA则可用于正向预测万古霉素PDC；所建预测模型各变量可解释万古霉素PDC 59.2%的变异。

Abstract

OBJECTIVE

To analyze the influencing factors for achieving target plasma drug concentration （trough）（abbreviated as “PDC”） of vancomycin in patients from high-altitude regions and establish a predictive model for PDC using single-center data， providing references for rational clinical drug use.

METHODS

Inpatients with vancomycin （1 g， q12 h） administered intravenously in our hospital from January 2021 to June 2024 were retrospectively included. Demographic data， liver and kidney function and hematological indexes were collected. Spearman correlation analysis was used to evaluate the correlation between vancomycin PDC and each detection index. Univariate analysis was used to evaluate the differences of each index in patients with different PDC， and the effects of different gender， body mass index， age and underlying diseases （hypertension/diabetes） on vancomycin PDC. Based on the results of correlation analysis and univariate analysis， multiple linear stepwise regression analysis was used to obtain the independent predictors of vancomycin PDC and construct the prediction model.

RESULTS

A total of 141 patients were included， with an overall attainment rate of 46.81% for the target PDC of vancomycin. Correlation analysis showed that the vancomycin PDC was positively correlated with age， blood urea nitrogen， uric acid （UA）， serum creatinine （CRE） and β

-microglobulin （β

-MG）， and nega

tively correlated with height， weight， creatinine clearance rate （CCR）， glomerular filtration rate （GFR）， alanine transaminase （ALT）， hemoglobin （HGB）， white blood cell count and neutrophils （

＜0.05）. There were significant differences in age， CRE and other 14 indexes among different PDC groups （

＜0.05 or

＜0.01）. Age and underlying diseases had significant effects on vancomycin PDC （

＜0.05 or

＜0.01）. CCR， direct bilirubin （DBil）， β

-MG， UA， HGB and height （standardized coefficients were －0.371， 0.367， 0.169， 0.232，－0.140，－0.132；

＜0.05） were independent predictors of vancomycin PDC. The

value of the regression equation was 34.858 （

＜0.05）， the

was 0.610， and the adjusted

was 0.592.

CONCLUSIONS

The vancomycin PDC of patients in high-altitude regions is affected by multiple factors such as renal function， liver function and hematological indexes. CCR， HGB and height could be used to predict vancomycin PDC negatively， while DBil， β

-MG and UA could be used to predict vancomycin PDC positively. The variables of the established prediction model could explain 59.2% of the variation of vancomycin PDC.

关键词

Keywords

references

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