替加环素对ICU重症感染患者凝血功能的影响及危险因素分析  

Influence of tigecycline on the coagulation function of ICU patients with severe infection and analysis of risk factors

作　　者：刘润 王龙[1] LIU Run;WANG Long(Department of Pharmacy,the Peopled Hospital of Gaozhou,Guangdong Province,Gaozhou 525200,China)

机构地区：[1]广东省高州市人民医院药剂科,525200

出　　处：《临床合理用药杂志》2021年第28期5-7,共3页Chinese Journal of Clinical Rational Drug Use

基　　金：茂名市科技计划项目(No:200326214553586)。

摘　　要：目的观察替加环素对ICU重症感染患者凝血功能的影响并分析危险因素。方法回顾性选择2019年2月-2020年4月广东省高州市人民医院ICU收治的使用替加环素治疗的重症感染患者64例。根据替加环素治疗剂量将患者分为高剂量组与常规组各32例。比较2组患者用药前后的凝血功能,采用二元Logistic回归方法分析替加环素导致ICU重症感染患者凝血功能异常的危险因素。结果用药后,2组患者凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)长于用药前,纤维蛋白原(FIB)、血小板(PLT)水平低于用药前,且高剂量组APTT长于常规组,PLT水平低于常规组(P<0.05)。2组患者用药后PT、FIB水平比较差异无统计学意义(P> 0.05)。二元Logistic回归分析结果显示,年龄、高剂量用药、用药时间> 14 d是ICU重症感染患者应用替加环素后出现凝血功能异常的危险因素(P<0.05)。结论替加环素可引起ICU重症感染患者凝血功能异常,且高龄、高剂量用药、用药时间>14 d是应用替加环素后出现凝血功能异常的危险因素,治疗期间应密切监测患者的凝血功能,及时发现凝血功能障碍并予以积极对症支持治疗。Objective To observe the effect of tigecycline on the coagulation function of severely infected patients in ICU and analyze the risk factors.Methods 64 patients with severe infection who were treated with tigecycline in ICU of the People′s Hospital of Gaozhou from February 2019 to April 2020 were selected.According to the dosage of tigecycline,they were divided into high-dose group and conventional group with 32 cases each.The coagulation function of the two groups of patients before and after the medication were compared,and the risk factors of tigecycline-induced abnormal coagulation function in ICU patients with severe infection were analyzed by the binary logistic regression method.Results After treatment,the prothrombin time(PT)and activated partial prothrombin time(APTT)of the two groups were longer than those before treatment,and the levels of fibrinogen(FIB)and platelet(PLT)were lower than before treatment,the APTT of the high-dose group was longer than that of the conventional group,and the PLT level was lower than that of the conventional group(P<0.05).There was no significant difference in PT and FIB levels between the two groups of patients after medication(P>0.05).The results of binary logistic regression analysis showed that older age,high-dose medication,and medication time>14 days were the risk factors for abnormal coagulation function in ICU patients with severe infection after tigecycline application(P<0.05).Conclusion Tigecycline can cause coagulation dysfunction in ICU patients with severe infection,older age,high-dose medication and medication time>14 days were the risk factors of coagulation dysfunction after application of tigecycline,during treatment,the coagulation indexes of patients should be closely monitored,coagulation dysfunction should be detected in time,and active symptomatic and supportive treatment should be given.

关 键 词：重症感染 替加环素 凝血功能 危险因素 

分 类 号：R969[医药卫生—药理学]