替加环素致低纤维蛋白原血症的危险因素及预测分析  

Risk factors and predictive analysis of tigecycline-induced hypofibrinogenemia

作　　者：胡章海 杨万枝[1] HU Zhang-hai;YANG Wan-zhi(Department of Pharmacy,Anqing First People's Hospital of Anhui Medical University/Anqing First People's Hospital,Anqing ANHUI 246003,China)

机构地区：[1]安徽医科大学附属安庆第一人民医院/安庆市第一人民医院药学部,安徽安庆246003

出　　处：《中国新药与临床杂志》2022年第11期685-690,共6页Chinese Journal of New Drugs and Clinical Remedies

基　　金：安庆市第一人民医院2021年“三新”立项项目(Y2021030)。

摘　　要：目的探讨替加环素致低纤维蛋白原血症(HFIB)的危险因素并建立预测模型。方法选取本院使用替加环素治疗的患者121例,按照31分成训练集和验证集,收集患者临床资料,通过单因素分析及多因素logistic回归分析,筛选替加环素致HFIB的独立危险因素,并据此构建预测模型,采用受试者操作特征(ROC)曲线对HFIB的发生情况予以预测与验证。结果训练集91例患者使用替加环素治疗期间有23例(25%)发生HFIB,疗程和基线纤维蛋白原(FIB)是发生HFIB的独立危险因素。建立logistic回归方程Y=-1.344+0.118X-0.679X。构建各危险因素及联合预测因子的ROC曲线,发现联合预测因子的曲线下面积最大;当联合预测因子的Youden指数最大(0.704)时,其在ROC曲线上最佳截断值为-2.702。30例验证集患者验证该模型准确率为87%。结论疗程和基线FIB为替加环素致HFIB的独立危险因素,两者拟合建立logistic回归模型对HFIB的发生具有预测价值。AIM To explore the risk factors of tigecycline-induced hypofibrinogenemia(HFIB)and establish the predictive model.METHODS Totally 121 patients treated with tigecycline in our hospital were selected,and divided into training set and validation set according to 31.The patients’clinical data were collected,the independent risk factors of HFIB induced by tigecycline were screened by univariate analysis and multivariate logistic regression analysis,and the predictive model was established.The occurrence of HFIB was predicted and verified by the receiver operating characteristic(ROC)curve.RESULTS Of the 91 patients in the training set,23 patients(25%)developed HFIB during the treatment with tigecycline.The treatment course(TC)and fibrinogen baseline(FB)were independent risk factors for the occurrence of HFIB.The logistic regression equation was established:Y=-1.344+0.118X-0.679X.By constructing ROC curves of the two risk factors and combined predictor,it was found that the area under the curve of combined predictor was the largest.When Youden index of combined predictor was the largest(0.704),the optimal cut-off value on ROC curve was-2.702.The accuracy of the model was 87%in the validation set of 30 patients.CONCLUSION TC and FB are independent risk factors of tigecycline-induced HFIB,and the logistic regression model fitted with the two factors has predictive value for the occurrence of HFIB.

关 键 词：替加环素 低纤维蛋白原血症 危险因素 预测模型 

分 类 号：R978.14[医药卫生—药品]