重症患者利奈唑胺所致血小板减少危险因素分析  

Analysis of risk factors associated with thrombocytopenia induced by linezolid in critical patients

作　　者：穆玉[1] 范春芳[2] 朱铁梁[2] 吴志恒[2] 

机构地区：[1]天津医科大学总医院ICU,300052 [2]武警医学院附属医院

出　　处：《中国感染与化疗杂志》2012年第1期10-14,共5页Chinese Journal of Infection and Chemotherapy

摘　　要：目的了解ICU危重患者利奈唑胺治疗中并发血小板减少症的情况及相关因素分析。方法回顾性分析65例患者的临床资料,单因素和多因素逐步Logistic回归分析利奈唑胺治疗中并发血小板减少症的相关危险因素。结果利奈唑胺治疗中并发血小板减少症的发生率为13.8%,并发血小板减少症组血小板基线值(PLT baseline)较未并发组低[(144.11±47.88)×109/L∶(234.96±112.82)×109/L,P=0.021],APACHEⅡ评分高[(24.67±5.15)∶(17.45±6.55),P=0.003];多因素逐步Logistic回归显示利奈唑胺治疗中并发血小板减少症的相关因素包括性别(OR57.03,95%CI 2.629～1237,P=0.010),用药时间(OR47.46,95%CI 1.814～1241,P=0.020)和APACHEⅡ评分(OR41.53,95%CI 2.695～640.0,P=0.008)。结论危重患者在使用利奈唑胺过程中应警惕血小板减少症的发生,尤其是血小板基线值≤200×109/L,APACHEⅡ评分≥20分和用药时间≥10 d的患者。Objective To investigate the prevalence and associated risk factors of thrombocytopenia induced by linezolid in critical patients in ICU. Methods The medical records of 65 patients were reviewed retrospectively. Risk factors associated with thrombocytopenia induced by linezolid were identified via univariate and multivariate logistic regression analysis. Results The prevalence of thrombocytopenia induced by linezolid in critical patients in ICU was 13.8% . Patients with thrombocytopenia had lower baseline platelet count [-（144. 11 ± 47.88） × 10^9/L ： （234.96 ± 112.82） × 10^9/L, p = 0. 021] and higher APACHE II score [（24.67 ± 5.15） ： （17.45 ± 6.55）, P = 0. 003]. Multivariate logistic regression analysis showed that gender （OR 57.03, 95% CI 2. 629-1237, P = 0. 010）, treatment duration （OR 47.46, 95% CI 1. 814-1241, P = 0. 020） and APACHE II score （OR 41.53, 95 % CI 2. 695-640.0, P = 0. 008） were significant risk factors for thrombocytopenia associated with linezolid therapy. Conclusions The patients should be closely monitored for thromboeytopenia during linezolid therapy in critical patients, especially when baseline platelet count ≤ 200 × 10^9/L, APACHE II score ≥20 and treatment duration 10 days.

关 键 词：利奈唑胺 血小板减少症 危险因素 

分 类 号：R595.3[医药卫生—内科学]