万古霉素相关急性肾损伤及肾功能未恢复危险因素分析  

Analysis of Risk Factors for Vancomycin-Associated Acute Kidney Injury and Failure to Recover Renal Function

作　　者：徐红艳 马菲 邓琴香 黄健 徐丙发[1,2] XU Hongyan;MA Fei;DENG Qinxiang;HUANG Jian;XU Bingfa(College of Pharmacy,Anhui Medical University,Hefei,Anhui,China 230061;The Third Hospital Affiliated to Anhui Medical University,Hefei,Anhui,China 230061)

机构地区：[1]安徽医科大学药学院,安徽合肥230061 [2]安徽医科大学第三附属医院,安徽合肥230061

出　　处：《中国药业》2024年第4期114-118,共5页China Pharmaceuticals

基　　金：安徽医科大学第三附属医院基础与临床合作研究提升计划培育项目[2022sfy016]。

摘　　要：目的探讨患者发生万古霉素相关急性肾损伤(VA-AKI)及VA-AKI患者肾功能未恢复的危险因素。方法选择医院2017年1月至2022年12月收治的使用万古霉素患者的临床资料,统计VA-AKI发生率及治疗药物监测(TDM)情况。分别采用单因素分析及多因素Logistic回归分析评估患者发生VA-AKI及肾功能未恢复的危险因素。结果共纳入158例患者,43例发生VA-AKI(27.22%);有145例患者需进行TDM,其中61例(42.07%)实际进行。多因素Logistic回归分析显示,合并心脏病[OR=0.036,95%CI(0.004,0.308),P=0.002],合并肿瘤[OR=0.103,95%CI(0.012,0.910),P=0.041],行外科手术[OR=0.060,95%CI(0.011,0.324),P=0.001]及联用袢利尿剂[OR=0.090,95%CI(0.022,0.378),P=0.001]是患者发生VA-AKI的独立危险因素;VA-AKI 3期[OR=24.788,95%CI(2.567,239.343),P=0.006]是VA-AKI患者肾功能未恢复的独立危险因素。结论合并心脏病、合并肿瘤、行外科手术、联用袢利尿剂是患者发生VA-AKI的独立危险因素;VA-AKI 3期是患者肾功能未恢复的独立危险因素。Objective To investigate the risk factors for vancomycin-associated acute kidney injury(VA-AKI)and failure to recover renal function in patients with VA-AKI.Methods Clinical data of patients treated with vancomycin in the hospital from January 2017 to December 2022 were collected,the incidence of VA-AKI and therapeutic drug monitoring(TDM)was analyzed.Univariate analysis and multivariate Logistic regression analysis were used to evaluate the risk factors for VA-AKI and failure to recover renal function in patients respectively.Results A total of 158 patients were included,43 of whom(27.22%)had VA-AKI,and 145 patients required TDM,61 of whom(42.07%)underwent it.The multivariate Logistic regression analysis showed that complication with heart disease[OR=0.036,95%CI(0.004,0.308),P=0.002],complication with tumors[OR=0.103,95%CI(0.012,0.910),P=0.041],surgery[OR=0.060,95%CI(0.011,0.324),P=0.001]and combination with loop diuretics[OR=0.090,95%CI(0.022,0.378),P=0.001]were the independent risk factors for VA-AKI in patients.VA-AKI stage three[OR=24.788,95%CI(2.567,239.343),P=0.006]was the independent risk factors for failure to recover renal function in patients with VA-AKI.Conclusion Complication with heart disease,tumors,surgery and combination with loop diuretics are the independent risk factors for VA-AKI in patients,and VA-AKI stages three is the independent risk factor for failure to recover renal function in patients.

关 键 词：万古霉素 急性肾损伤 危险因素 肾功能恢复 LOGISTIC回归分析 

分 类 号：R969.3[医药卫生—药理学]