利奈唑胺致贫血的危险因素分析及预测模型建立  

Risk factors for linezolid-induced anemia and the establishment of prediction model

作　　者：沈赟 秦艳 陈喆 叶岩荣 戴佩芳 李晓宇 吕迁洲 SHEN Yun;QIN Yan;CHEN Zhe;YE Yan-rong;DAI Pei-fang;LI Xiao-yu;LV Qian-zhou(Department of Pharmacy,Zhongshan Hospital,Fudan University,Shanghai 200032)

机构地区：[1]复旦大学附属中山医院药剂科,上海200032

出　　处：《中南药学》2020年第9期1572-1576,共5页Central South Pharmacy

基　　金：上海市临床重点专科(临床药学)项目(No.shslczdzk06504);复旦大学附属中山医院青年基金项目(No.2020ZSQN53)。

摘　　要：目的探讨利奈唑胺相关贫血的危险因素并建立预测模型评估贫血发生的风险。方法采用回顾性分析,从本院电子病历系统收集2018年1月至2020年5月期间使用利奈唑胺治疗的住院患者信息,将其分为贫血组和非贫血组,对患者的基本信息、生化检查和用药情况等相关指标进行统计分析,筛选出发生贫血的独立危险因素,并建立Logistic回归预测模型,采用ROC曲线评估模型的预测价值。结果共99名患者(男性58例,58.6%)纳入研究,使用利奈唑胺治疗期间20名患者(20.2%)发生贫血。多因素Logistic回归分析结果显示,用药天数、总胆红素和估算的肾小球滤过率是利奈唑胺致贫血的独立危险因素。根据Logistic回归预测模型的结果,构建各独立危险因素和联合预测因子的ROC曲线,联合预测因子的ROC曲线下面积为0.921,高于其他单一指标,Youden指数最大时(0.749)对应ROC曲线上的临界值为14.4。结论利奈唑胺的用药时间、总胆红素和估算的肾小球滤过率是贫血发生的独立危险因素,临床用药期间可通过上述各危险因素计算联合预测因子值,当预测结果大于临界值14.4时,表明贫血发生的风险较高,应加强血常规监测。Objective To identify the risk factors for linezolid-induced anemia and establish the Logistic regression prediction model.Methods We retrospectively collected demographic and laboratory data of inpatients from January 2018 to May 2020 who were undergoing linezolid treatment.The patients were divided into an anemia group and a non-anemia group to compare the difference between them,and further analyzed them by Logistic regression to identify the risk factors for linezolid-induced anemia.Then the prediction model was established.ROC curve was drawn to predict the risk of anemia.Results Totally 99 patients(58 males,58.6%)were included in the study,and 20(20.2%)developed anemia during the linezolid treatment.In multivariate Logistic regression analysis,the duration of linezolid therapy,total bilirubin and eGFR were significant risk factors for linezolid-induced anemia.Based on the Logistic regression prediction model,the ROC curve of independent risk factors and joint predictor were established,and the area under the ROC curve of joint predictor was 0.921,which was larger than the other three single indicators.The cutoff value was 14.4 when the Youden index was the largest at 0.749.Conclusion The duration of linezolid therapy,total bilirubin and eGFR are independent risk factors of linezolid-induced anemia.In clinical practice,we should calculate the joint predictor by the above index.When the result is greater than the cut-off value(14.4),it indicates that the risk of linezolid-induced anemia is high and routine blood monitoring should be strengthened.

关 键 词：利奈唑胺 贫血 危险因素 预测模型 

分 类 号：R542[医药卫生—心血管疾病]