万古霉素联用哌拉西林他唑巴坦致急性肾损伤的研究进展  

Research progress of vancomycin combined with piperacillin/tazobactam induced acute kidney injury

作　　者：林小青 尹文俊[2] 周凌云[2] 谢悦良[2] 汪江林[2] 左笑丛 Xiao-Qing LIN;Wen-Jun YIN;Ling-Yun ZHOU;Yue-Liang XIE;Jiang-Lin WANG;Xiao-Cong ZUO(School of Pharmacy,Zunyi Medical University,Zunyi 563000,Guizhou Province,China;Department of Pharmacy,The Third Xiangya Hospital of Central South University,Changsha 410013,China;Center of Clinical Pharmacology,The Third Xiangya Hospital of Central South University,Changsha 410013,China)

机构地区：[1]遵义医科大学药学院,贵州遵义563000 [2]中南大学湘雅三医院药学部,长沙410013 [3]中南大学湘雅三医院临床药理中心,长沙410013

出　　处：《药物流行病学杂志》2023年第9期975-984,共10页Chinese Journal of Pharmacoepidemiology

基　　金：国家自然科学基金面上项目(81973400);国家自然科学基金青年科学基金项目(82104305);国家自然科学基金区域创新发展联合基金项目(U22A20386);湖南省自然科学基金项目(2021JJ40957);湖南省工程研究中心建设项目(湘发改高技[2020]1006号,编号40);湖南省重点领域研发计划重点研发项目(2022SK2021)。

摘　　要：万古霉素与哌拉西林他唑巴坦联用是临床常见的联合治疗方案,该方案治疗成本较低,可同时覆盖耐甲氧西林金黄色葡萄球菌和假单胞菌,常用于重症监护病房的患者,在严重感染如急性脓毒症患者的一线治疗中发挥着关键作用。但多项临床研究表明该联用方案可能会增加急性肾损伤的发生风险,导致治疗失败和住院时间延长,严重时可危及患者生命安全。因此,本研究对万古霉素与哌拉西林他唑巴坦联用致急性肾损伤的流行病学、发病机制和防治措施进行综述,旨在为临床安全使用万古霉素和哌拉西林他唑巴坦提供依据。Vancomycin combined with piperacillin/tazobactam is a common clinical treatment regimen.This low-cost regimen covers both methicillin-resistant Staphylococcus aureus(MRSA)and Pseudomonas adaceae,and it is commonly used in patients in intensive care units,and it plays a key role in the first-line treatment of patients with severe infections such as acute sepsis.However,multiple clinical studies have shown this combination regimen may increase the risk of acute kidney injury,resulting in treatment failure,prolonged hospital stay,and even the life-threatening of patients in severe cases.Therefore,this study reviewed the epidemiology,pathogenesis,prevention and treatment of acute kidney injury induced by vancomycin combined with piperacillin/tazobactam,in order to provide evidence for the safe use of vancomycin and piperacillin/tazobactam in clinic.

关 键 词：万古霉素 哌拉西林他唑巴坦 急性肾损伤 联合用药 

分 类 号：R969[医药卫生—药理学]