摘要
目的探讨利奈唑胺所致血小板减少的危险因素。方法回顾性分析197例接受利奈唑胺治疗的住院患者的临床资料，并对利奈唑胺治疗中并发血小板减少的相关危险因素进行二元Logistic回归分析。结果利奈唑胺治疗中并发血小板减少的发生率为13．71％。发生血小板减少组年龄较未并发血小板减少组大[（68．52±13．46）岁掷（61．33±17．26）岁，P=0．008]，血清肌酐清除率（CCr）[（71．17±48．60）mL·min^-1 vs （92．61±51．72）mL·min^-1，P=0．022]和基础血小板值[（193．07±70．93）×10^9·L^-1 vs （278．25±129．46）×10^9·L^-1，P=0．001]较低。二元Logistic回归分析显示利奈唑胺治疗中并发血小板减少的危险因素包括年龄（OR3．12，95％CI1．30～7．53，P=0．01），CCr（OR5．69，95％CI2．29～14．14，P=0．00），ALT（OR2．75，95％CI1．03～17．35，P=0．04），AST（OR4．08，95％CI1．37～12．18，P=0．01），总胆红素（OR4．02，95％CI1．23～13．08，P=0．02）和基础血小板值（OR5．53，95％CI2．01～15．24，P=0．00）。结论 临床使用利奈唑胺的过程中应警惕血小板减少的发生，尤其是年龄〉65岁、CCr≤40mL·min^-1、ALT〉70 U·L^-1、AST〉80U·L^-1、总胆红素〉65μmol·L^-1或基础血小板值≤175×10^9·L^-1的患者。
AIM To investigate the risk factors for linezolid-associated thrombocytopenia. METHODS The med- ical records of 197 patients received linezolid therapy were collected retrospectively. Risk factors associated with thrombo- cytopenia induced by linezolid were identified via Binary Logistic regression analysis. RESULTS The incidence of thrombocytopenia induced by linezolid was 13.71%. Patients with thrombocytopenia were older [ （68.52 ± 13.46） years ： （61.33 ± 17.26）years, P = 0.008], and lower CCr [ （71.17 ±48.60） mL·min^-1 vs （92.61± 51.72） mL·min^-1, P = 0.022] and baseline platelet count [ （ 193.07 ± 70.93） ×10^9· L^- 1 vs （278.25± 129.46） ×10^9·L^- 1, p = 0. 001 ]. Binary Logistic regression analysis showed that risk factors associated with thrombocytopenia induced by linezolid were age （OR 3.12,95% CI 1.30-7.53,P=0.01）,CCr （OR 5.69,95% CI 2.29- 14.14, P = 0.00）,ALT （OR 2.75,95% CI 1.03-27.35, P=0.04）,AST （OR 4.08,95% CI 1.37- 12.18, P=0.01）,total bilirubin （OR 4.02,95% CI 1.23- 13.08,P=0.02） and baseline platelet count（OR 5.53,95% CI 2.01- 15.24, P=0.00）. CONCLUSION Clinical use of linezolid should be wary of the incidence of thrombocytopenia during linezolid therapy, especially when age 〉 65 years, CCr ≤ 40 mL·min^- 1, ALT 〉 70 U·L^- 1, AST 〉 80 U·L^-1, total bilirubin 〉 65 μmol· L^- 1 or baseline platelet count≤175 × 10^9 ·L^- 1.
出处
《中国临床药学杂志》
CAS
2014年第4期222-225,共4页
Chinese Journal of Clinical Pharmacy
