74例替加环素对凝血功能影响的分析  

Effects of Tigecycline on Coagulation Function of 74 Patients

作　　者：徐姗姗[1] 宋智慧[1] 韩芙蓉[1] 张弨 XU Shanshan;SONG Zhihui;HAN Furong;ZHANG Chao(Department of Pharmacy,BeijingTongren Hospital of Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院药学部,北京100730

出　　处：《中国药物警戒》2021年第12期1181-1185,共5页Chinese Journal of Pharmacovigilance

摘　　要：目的探讨替加环素对患者凝血功能的影响。方法收集2017年1月1日至2019年12月31日我院74例使用替加环素患者的临床资料,并记录替加环素治疗前、治疗期间及停药后外周血纤维蛋白原(FIB)、凝血酶原时间(PT)、部分激活凝血酶原时间(aPTT)、凝血酶时间(TT)、国际标准化比值(INR)、D-二聚体(D-dimer)、血小板(PLT)、谷丙转氨酶(ALT)、总胆红素(Tbil)和肌酐(CREA)水平,评估替加环素对患者凝血指标的影响。结果与治疗前比较,治疗期间患者血浆FIB水平明显下降,aPTT、PT、TT和INR水平明显增加(P<0.05)。90.54%患者治疗期间FIB下降,其中47.76%下降程度超过50%。FIB下降程度与替加环素治疗前FIB基线水平呈正相关(R2=0.726,P<0.001)。停药后,FIB在第6天恢复至治疗前水平(差异无统计学意义),aPTT、PT、TT和INR均在停药后第2天即可恢复至治疗前水平(差异无统计学意义)。患者用药前后ALT、Tbil、CREA和PLT水平比较差异均无统计学意义(P>0.05)。结论替加环素可引起PT、aPTT、TT、INR延长和FIB下降,其中FIB下降是应用替加环素患者出现凝血功能异常的关键环节,使用该药物期间需严密监测凝血功能。Objective To study the effects of tigecycline on coagulation function of patients.Methods The clinical data on 74 inpatients who used tigecycline at Beijing Tongren Hospital between January 1,2017 and December 31,2019 was collected.The levels of fibrinogen(FIB),prothrombin time(PT),activated partial thromboplastin time(aPTT),thrombin time(TT),international normalized ratio(INR),and levels of D-dimer,platelets(PLT),alanine aminotransferase(ALT),total bilirubin(Tbil)and creatinine(CREA)before,during and after medication were recorded to assess the effect of tigecycline on coagulation function.Results The FIB level was significantly decreased while the median levels of aPTT,PT,TT and INR were all significantly increased(P<0.05).Spearman correlation coefficients revealed a strong positive association between the extent to which FIB declined and the baseline level of this parameter(R2=0.726,P<0.001).The FIB level returned to the pre-treatment level at day 6 after discontinuation,so did the levels of aPTT,PT,TT and INR at day 2 after discontinuation.There was no statistically significant difference in levels of ALT,Tbil,CREA and PLT before or after medication(P>0.05).Conclusion Tigecycline can prolong PT,aPTT,TT,INR and reduce the level of FIB.The decline of FIB is the key to abnormal coagulation function among patients who use tigecycline.The coagulation function should be closely monitored when the drug is used.

关 键 词：替加环素 凝血功能障碍 纤维蛋白原 

分 类 号：R978.1[医药卫生—药品]