抗菌药物使用对顺铂急性肾损伤的影响  

Effect of antimicrobial drug use on cisplatin-induced acute renal injury

作　　者：黄丽 魏龙 HUANG Li;WEI Long(The Department of Pharmacy,Zhuzhou Central Hospital,Zhuzhou,Hunan 412000,China)

机构地区：[1]株洲市中心医院药学部,湖南株洲412000

出　　处：《安徽医药》2023年第12期2503-2506,共4页Anhui Medical and Pharmaceutical Journal

基　　金：湖南省自然科学基金科药联合基金项目(2021JJ80089)。

摘　　要：目的探讨顺铂化疗前21 d内或化疗期间抗菌药物使用是否增加顺铂急性肾损伤(AKI)发生风险。方法以2020年5月至2021年4月株洲市中心医院诊断为癌症且使用了顺铂化疗的病人1075例为研究对象,根据顺铂用药前21 d内或顺铂用药期间是否使用抗菌药物将病人分为暴露组(n=155)和对照组(n=950),通过倾向性评分匹配法均衡人口统计学及肿瘤相关变量等混杂因素,比较两组病人AKI发生率。结果倾向性评分匹配后,共151对匹配成功,暴露组的151例病人中有37例(24.5%)发生AKI,对照组151例病人中有23例(15.2%)发生AKI,暴露组AKI发生率高于对照组,差异有统计学意义(P<0.05)。不同类别的抗菌药物(β内酰胺类、喹诺酮类、硝基咪唑类),抗菌药物单药或联合,不同的抗菌药物用药疗程,顺铂急性肾损伤发生率差异无统计学意义(P>0.05)。结论真实世界中,顺铂化疗前21 d内或化疗期间使用抗菌药物增加顺铂急性肾损伤发生风险。Objective To investigate whether antimicrobial drug use within 21 days before or during cisplatin chemotherapy increases the risk of acute kidney injury with cisplatin.Methods The study focuses on 1075 patients diagnosed with cancer and treated with cisplatin chemotherapy at Zhuzhou Central Hospital from May 2020 to April 2021.According to whether antimicrobial drugs were used within 21 days before or during cisplatin administration,the patients were divided into exposure(n=155)and control groups(n=950).The incidence of acute kidney injury in the two groups was compared by balancing demographic and tumor-related variables and other confounding factors by the propensity score matching method.Results After propensity score matching,a total of 151 matched pairs were successful,and AKI occurred in 37(24.5%)of the 151 patients in the exposure group and 23(15.2%)of the 151 patients in the control group.The incidence of AKI in the exposure group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of acute kidney injury of cisplatin between different classes of antimicrobial drugs(β-lactams,quinolones,nitroimidazoles),antimicrobial drugs alone or in combination,and different courses of antimicrobial drug administration(P>0.05).Conclusion In the real world,the use of antimicrobial drugs within 21 days before or during cisplatin chemotherapy increases the risk of acute kidney injury with cisplatin.

关 键 词：药物相关性副作用和不良反应 急性肾损伤 药物疗法 抗菌药 顺铂 倾向性评分匹配 

分 类 号：R692[医药卫生—泌尿科学]