药学 开题报告范文荐读

开题报告是研究生实施毕业论文课题研究的前瞻性计划和依据，下面是小编搜集整理的药学毕业论文开题报告范文荐读，欢迎阅读查看。

1、选题意义和背景：

万古霉素(Vancomycin, VCM)是糖肽类抗生素，1958 年被美国 FDA 批准上市。万古霉素通过干扰细菌细胞壁合成而发挥杀菌作用。本品主要对革兰阳性(G+)菌具有强大的杀菌活性，特别是耐甲氧西林金黄色葡萄球菌(Methicillin-resistant staphylococcus aureus, MRSA)以及耐甲氧西林凝固酶阴性葡萄球菌(Methicillin resistant coagulase negative staphylococcus, MRCNS)[2].根据 2012 年中国 CHINET 细菌耐药性监测，MRSA 和 MRCNS 检出率分别平均为47.9%和 77.1%[3].由于医院内上述耐药菌感染日趋严重，万古霉素越来越多地被应用于临床。然而，万古霉素具有肾、耳毒性，严重者可导致肾衰竭或听力丧失，这些不良反应在老年人中更易出现。因此，安全有效的应用该药物，最大程度减少药物对患者的损害，并发挥药物的最佳疗效，引起临床高度关注。

2、论文综述/研究基础：

近年来，国内外关于万古霉素群体药动学(Population pharmacokinetics, PPK)研究涉及新生儿、成年人、肥胖患者、肾功能不全患者等人群。Sanchez 等[4]在141 例应用万古霉素的患者中发现，老年人(65 岁，n=40)清除率(Clearancerate, CL)和表观分布容积(Apparent volume of distribution, V)分别为(2.24 1.2)Lh-1和(43.7 5.1)L,而年轻人(65 岁，n=101)CL 和 V 则分别为(4.03 1.7)Lh-1和(28.4 5.3)L,两个群体之间存在统计学差异(p0.05)。

福建医科大学附属第一医院药学部课题组前期已建立成年患者万古霉素PPK 模型，可以为临床制定万古霉素给药方案提供参考依据。为了进一步完善这一体系，本研究拟建立老年患者万古霉素 PPK 模型，辅助临床实现个体化给药。

3、参考文献：

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4、论文提纲

第一部分 万古霉素血药浓度监测

1 方法学简述

2 EMIT 法测定万古霉素血药浓度

3 讨论

4 小结

第二部分 老年患者万古霉素群体药动学模型的建立

1 材料与方法

2 结果

3 讨论

4 小结

5、论文的理论依据、研究方法、研究内容

本研究应用 NONMEM 法初步建立了老年患者万古霉素 PPK 模型，考察了年龄、体重、肾功能、合并用药对万古霉素清除率的影响，发现 CLCr是万古霉素药动学参数的主要影响因素。模型验证结果显示，最终模型稳定、有效，具有良好的预测能力。

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