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以下描述的是肝肾功能障碍病人万古霉素清除率同肌酐廓清率估计值和测定值之间不成比例的低相关性。一名77岁男性患者,患有二尖瓣和主动脉狭窄、慢性心房纤颤、细菌性心内膜炎和肝硬变,因发热、寒颤、神志不清而入院。查体有心律不齐和Ⅲ/Ⅵ级收缩渐强性杂音。肝脏轻微肿大,血清肌酐浓度为1.5mg/dl。以头孢唑林、妥布拉霉素、地高辛、呋喃苯胺酸、螺内酯(Spironolactone)、氯化钾、华法林进行药物治疗,病人退热,症状好转。第8天病人开始发烧,停用头孢唑林和妥布拉霉素,开始以万古霉素(盐酸
Described below is a disproportionately low correlation between vancomycin clearance and creatinine clearance estimates and measured values in patients with liver and kidney dysfunction. A 77-year-old man with mitral and aortic stenosis, chronic atrial fibrillation, bacterial endocarditis and cirrhosis was hospitalized for fever, shivering and confusion. Check the body with arrhythmia and Ⅲ / Ⅵ contraction shrinking murmur. Liver slightly enlarged, serum creatinine concentration of 1.5mg / dl. Cefazolin, tobramycin, digoxin, furosemide acid, spironolactone, potassium chloride, warfarin for drug treatment, patients with fever, the symptoms improved. On the 8th day, the patient started to have a fever, and cefazolin and tobramycin were discontinued. Vancomycin (hydrochloric acid