利奈唑胺致血红蛋白减少危险因素的Meta分析  

Meta-analysis of risk factors for hemoglobin reduction caused by linezolid

作　　者：自雪梅 张峻[2] 柳汝明[2] 何瑾[2] ZI Xuemei;ZHANG Jun;LIU Ruming;HE Jin(Pharmacy Department,The People′s Hospital of Chuxiong Yi Autonomous Prefecture,Yunnan Province,Chuxiong 675099,China;不详)

机构地区：[1]楚雄彝族自治州人民医院药剂科,云南省楚雄市675099 [2]昆明医科大学第一附属医院临床药学科,昆明市650032

出　　处：《临床合理用药杂志》2024年第4期26-30,共5页Chinese Journal of Clinical Rational Drug Use

基　　金：云南省高层次卫生计生技术人才培养专项经费资助项目(D-2018042,H-2018081);云南省基础研究计划(昆明医科大学联合专项)项目(202101AY070001-091);云南省科技厅—昆明医科大学应用基础研究联合专项[2019FE001(-200)]。

摘　　要：目的 系统评价利奈唑胺致血红蛋白减少的危险因素,为临床用药提供参考。方法 通过计算机检索中国知网、PubMed、万方数据知识服务平台、Embase、Cochrane Library、中国生物医学文献数据库,文献检索时间为数据库成立至2021年9月。收集利奈唑胺致血红蛋白减少危险因素的临床研究,其中,发生血红蛋白减少者为HP组,未发生血红蛋白减少者为NHP组。对符合标准的文献进行资料提取,并采用纽卡斯尔—渥太华质量评估量表(NOS)对纳入文献进行质量评价,采用RevMan 5.4软件进行Meta分析。结果 纳入研究8项,患者1 715例。Meta分析结果显示,HP组肾小球滤过率[SMD=-26.72,95%CI(-35.18,-18.25),P<0.000 01]、基础血红蛋白水平[SMD=3.43,95%CI(0.96,5.91),P=0.007]低于NHP组,用药疗程[SMD=2.09,95%CI(1.10,3.09),P<0.000 1]长于NHP组,谷浓度[SMD=3.25,95%CI(1.67,4.84),P<0.000 1]、血肌酐[SMD=43.11,95%CI(21.35,64.86),P=0.000 1]、总胆红素[SMD=2.16,95%CI(0.74,3.58),P=0.003]水平高于NHP组。结论 肾小球滤过率低、用药疗程长、谷浓度高、血肌酐水平高、基础血红蛋白水平低、总胆红素水平高是利奈唑胺致血红蛋白减少的危险因素。Objective To systematically evaluate the risk factors of hemoglobin reduction caused by linezolid,and to provide reference for clinical use.Methods Retrieved from CNKI,PubMed,Wanfang database,Embase and Cochrane library,CBM,the literature search time was from the establishment of database to September 2021.Clinical studies about risk factors of linezolid-induced haemoglobinia were collected,with those who had hemoglobinopenia in the HP group and those who did not experience hemoglobinopenia in the NHP group.The data of literatures met criteria were collected,after Newcastle-Ottawa scale(NOS)was applied for evaluating the quality of included literatures,meta-analysis was conducted by using RevMan 5.4 software.Results Eight studies with 1715 patients were included.Meta-analysis showed that,the glomerular filtration rate[SMD=-26.72,95%CI(-35.18,-18.25),P<0.00001]and basal hemoglobin level[SMD=3.43,95%CI(0.96,5.91),and P=0.007]were lower than those of the NHP group,and the course of medication[SMD=2.09,95%CI(1.10,3.09),the P<0.0001]was longer than that of the NHP group,and the trough concentration[SMD=3.25,95%CI(1.67,4.84),P<0.0001],blood creatinine[SMD=43.11,95%CI(21.35,64.86),P=0.0001],total bilirubin[SMD=2.16,95%CI(0.74,3.58),P=0.003]were higher than those of the NHP group.Conclusion The risk factors associated with linezolid-induced haemoglobinia include low creatinine clearance rate,long medication course,high valley concentrations,high serum creatinine,,and low baseline hemoglobin count,high total bilirubin.

关 键 词：利奈唑胺 血红蛋白 减少 危险因素 META分析 

分 类 号：R978[医药卫生—药品]