利奈唑胺致血红蛋白减少的相关危险因素  

Analysis of related risk factors for linezolid induced hemoglobin reduction

作　　者：王海静 王盈盈[1] 许巧巧[1] 陈婷[1] WANG Haijing;WANG Yingying;XU Qiaoqiao;CHEN Ting(Department of Pharmacy,the Affiliated Hospital of Wenzhou Medical University^Wenzhou 325000,China)

机构地区：[1]温州医科大学附属第一医院药学部,温州325000

出　　处：《中国临床药学杂志》2020年第5期355-359,共5页Chinese Journal of Clinical Pharmacy

摘　　要：目的探讨住院患者使用利奈唑胺致血红蛋白减少的相关危险因素。方法筛选2016年1月至2019年5月使用利奈唑胺且监测药物谷浓度(ρmin)在6 mg·L-1以上的住院患者为研究对象,采用单因素及多因素逐步Logistic回归法分析利奈唑胺致血红蛋白减少的相关危险因素,绘制ROC曲线预测临床发生特征。结果入选有效病例104例,其中31例被评估为利奈唑胺相关的血红蛋白减少。单因素分析显示血清总蛋白、肾小球滤过率(GFR)、接受连续肾脏替代疗法(CRRT)和利奈唑胺谷浓度具有统计学意义;多因素Logistic回归分析显示GFR<60 mL·min-1·(1.73 m2)-1和药物谷浓度与利奈唑胺相关性血红蛋白减少密切相关。绘制利奈唑胺谷浓度ROC曲线下面积为0.663,Youden指数最大为0.276,对应临界值为9.339 mg·L-1,灵敏度为74.2%,特异性为46.6%。结论中重度肾功能不全的患者使用利奈唑胺时应增加血常规的监测频率。药物谷浓度对利奈唑胺致血红蛋白减少具有一定的预测价值,可通过监测患者血药浓度来提高用药安全性。AIM To investigate the risk factors associated with inpatients using linezolid for hemoglobin reduction. METHODS Patients admitted to our hospital from January 2016 to May 2019 who were treated with linezolid and the valley concentration(ρmin)was more than 6 mg·L-1,univariate and multivariate stepwise logistic regression analysis was conducted to analyze the related risk factors,and relative operating characteristic(ROC)curve was drawn to predict clinical features. RESULTS A total of 104 valid patients were enrolled,among which 31 patients were assessed as linezolid related reduction in hemoglobin. The univariate analysis showed that serum total protein, glomerular filtration rate(GFR), continuous renal replacement therapy(CRRT) and linezolid valley concentration were statistically significant. Multivariate logistic regression analysis showed that GFR <60 mL·min-1·(1.73 m2)-1, and drug valley concentration was closely related to linezolid related hemoglobin reduction. The area under the ROC curve of linezolid valley concentration was 0.663, the Youden index was 0.276 at the maximum, and the corresponding critical value was 9.339 mg·L-1, with a sensitivity of 74.2% and a specificity of 46.6%. CONCLUSION Inpatients with severe renal insufficiency,the frequency of blood routine monitoring must be enhanced when using linezolid. Valley concentration has a high predictive value for linezolid induced hemoglobin reduction, and monitoring blood drug concentrations can improve the drug safety.

关 键 词：利奈唑胺 血红蛋白减少 危险因素 血药浓度 

分 类 号：R969[医药卫生—药理学]