头孢哌酮钠舒巴坦钠致慢性肾功能不全患者凝血功能异常的影响因素分析  

Analysis of influencing factors of coagulation disorders caused by cefoperazone sodium and sulbactam sodium in patients with chronic renal insufficiency

作　　者：严远梅 郑粤欣 麦露丝[1] 常惠礼[1] Yan Yuanmei;Zheng Yuexin;Mai Lusi;Chang Huili(Department of Pharmacy,Affiliated Qingyuan Hospital,Guangzhou Medical University,Qingyuan People′s Hospital,Guangdong Province,Qingyuan 511518,China;School of Pharmacy,Guangzhou Medical University,Guangzhou 511436,China)

机构地区：[1]广州医科大学附属清远医院(清远市人民医院)药学部,清远511518 [2]广州医科大学药学院,广州511436

出　　处：《药物不良反应杂志》2024年第5期280-284,共5页Adverse Drug Reactions Journal

摘　　要：目的探讨头孢哌酮钠舒巴坦钠致慢性肾功能不全患者凝血功能异常的影响因素。方法收集广州医科大学附属清远医院(清远市人民医院)肾内科2021年1月至2022年12月使用头孢哌酮钠舒巴坦钠进行抗感染治疗的慢性肾功能不全成年住院患者的病历资料,筛选出与头孢哌酮钠舒巴坦钠相关凝血功能异常(终点事件)的患者,对肾功能不全患者终点事件的发生情况进行描述性分析。根据是否发生终点事件,将患者分为终点事件组和无终点事件组,对终点事件的发生风险进行单因素和多因素logistic回归分析。结果总共121例患者纳入分析,其中男性76例(62.8%),女性45例(37.2%);年龄(66±13)岁。121例肾功能不全患者中39例(32.2%)发生终点事件,6例(5.0%)有临床出血表现。单因素分析结果显示,发生与未发生终点事件组患者的年龄、肾替代治疗及头孢哌酮钠舒巴坦钠的日剂量和总剂量的差异均有统计学意义(均P<0.05)。以患者是否发生终点事件为因变量,以年龄、肾替代治疗以及头孢哌酮钠舒巴坦钠的日剂量和总剂量为自变量代入logistic回归分析,结果显示仅患者高龄为终点事件发生的独立危险因素(比值比=1.044,95%置信区间:1.004~1.086,P=0.029)。结论肾功能不全患者使用头孢哌酮钠舒巴坦钠治疗导致凝血功能异常的风险较高,高龄是凝血功能异常发生的独立危险因素。老年肾功能不全患者应谨慎使用头孢哌酮钠舒巴坦钠,临床使用时应加强凝血功能的监测。Objective cefoperazone sodium and sulbactam sodium in patients with chronic renal insufficiency To explore the influencing factors of coagulation disorders caused by.Methods The medical records of adult patients with chronic renal insufficiency,who were hospitalized and treated with cefoperazone sodium and sulbactam sodium in the Department of Nephrology of the Affiliated Qingyuan Hospital,Guangzhou Medical University,Qingyuan People′s Hospital from January 2021 to December 2022,were collected.Patients who developed coagulation disorders related to cefoperazone sodium and sulbactam sodium were imputed as having an end⁃point event,these patients was analyzed descriptively and the occurrence of end⁃point events in.According to whether an end⁃point event occurred,patients were divided into end⁃point event group and non⁃end point event group.Univariate and multivariate logistic regression analysis were performed on the risk of end⁃point events.Results A total of 121 patients with renal insufficiency were included in the analysis,including 76 males(62.8%)and 45 females(37.2%),aged(66±13)years.Among 121 patients,39(32.2%)had end⁃point events,and 6(5.0%)had clinical bleeding.The results of univariate analysis showed that the differences in age,renal replacement therapy,and daily and total doses of cefoperazone sodium and sulbactam sodium of patients between 2 groups were statistically significant(all P<0.05).Multivariate logistic regression analysis was performed using the occurrence of end⁃point events as dependent variables,and age,renal replacement therapy,and daily and total doses of cefoperazone sodium and sulbactam sodium as independent variables.The results showed that only older age was an independent risk factor for the occurrence of end⁃point events(odds ratio=1.044,95 interval:1.004%confidence-1.086,P=0.029).Conclusions Patients with renal insufficiency have a higher risk of coagulation disorders in treatment with cefoperazone sodium and sulbactam sodium,and older age independent risk is

关 键 词：肾功能不全 慢性 头孢哌酮 舒巴坦 凝血异常 危险因素 

分 类 号：R692[医药卫生—泌尿科学]