利奈唑胺相关血小板减少危险因素的Meta分析  

Meta-analysis of risk factors for thrombocytopenia related to linezolid

作　　者：戈梦佳 陈恳[1,2] 马青变[3] 易湛苗[1] 翟所迪[1] 

机构地区：[1]北京大学第三医院药剂科,100191 [2]北京大学药学院药事管理与临床药学系,100191 [3]北京大学第三医院急诊科,北京100191

出　　处：《药物不良反应杂志》2016年第6期405-411,共7页Adverse Drug Reactions Journal

摘　　要：目的综合评价利奈唑胺相关血小板减少的危险因素。方法检索有关数据库，收集建库至2016年6月收录的有关利奈唑胺相关血小板减少危险因素的病例对照研究，依据渥太华-纽卡斯尔质量评估量表（NOS）对纳入文献进行质量评价，采用 RevMan 5.3软件进行 Meta 分析，结果用 OR 及其95% CI 表示。结果纳入分析的文献为25篇，NOS 评分均≥7分。涉及4279例患者，其中血小板减少组1335例，无血小板减少组2944例。Meta 分析结果显示，利奈唑胺相关血小板减少的危险因素为基础 PLT ＜200×10^9∕ L（OR =3.64，95% CI：1.60～8.30，P =0.002），体重＜50 kg （OR =2.44，95% CI：1.79～3.34，P ＜0.001），肌酐清除率＜30 ml∕ min（OR =1.85，95% CI：1.29～2.67，P ＜0.001，用药疗程＞14 d（OR =1.76，95% CI：1.17～2.65，P =0.006），以及年龄≥65岁（OR =1.54，95% CI：1.03～2.31，P =0.04）。结论肾功能重度损伤、基础 PLT 低、低体重、用药疗程长和高龄为利奈唑胺相关血小板减少的危险因素。Objective To evaluate the risk factors for thrombocytoenia related to linezolid（LZD） comprehensively. Methods The related databases were electronically searched for the case-control studies about risk factors for LZD-associated thrombocytoPenia from the incePtion to June 2016. The quality of the literature which was enrolled into the Meta-analysis evaluated by Newcastle-Ottawa Quality Assessment Scale （NOS）,and then Meta-analysis was conducted using RevMan 5. 3 software. The results are Presented as odds risk（ OR）and 95% confidence interval（ CI）. Results A total of 25 studies involving 4 279 Patients were entered, including 1 335 in the thrombocytoPenia grouP and 2 944 in the none thrombocytoPenia grouP. The NOS scores of all literature were greater than or equal to 7. The result of Meta-analysis showed that,the baseline Platelet count 〈 200 × 109 ∕ L（OR = 3. 64,95% CI：1. 60-8. 30,P =0. 002）,body weight 〈 50 kg（OR = 2. 44,95% CI：1. 79-3. 34,P 〈 0. 001）,creatinine clearance 〈 30 ml∕ min（OR = 1. 85,95% CI：1. 29-2. 67,P 〈 0. 001）,duration of LZD theraPy 〉 14 days（OR = 1. 76, 95% CI：1. 17-2. 65,P = 0. 006）and age≥65 years（OR = 1. 54,95% CI：1. 03-2. 31,P = 0. 04）were identified as significant risk factors for LZD-associated thrombocytopenia. Conclusion Current evidence shows that the severe damage to renal function,low baseline Platelet count,low body weight,long-term LZD administration and advanced age are risk factors of LZD-related thrombocytopenia.

关 键 词：利奈唑胺 血小板减少 危险因素 META分析 

分 类 号：R978[医药卫生—药品]