万古霉素相关急性肾功能损伤危险因素分析  

Risk Factors for Vancomycin-related Acute Renal Injury

作　　者：汪佳 万佳锋 方慧 邹杰 郑英 戴美琴 WANG Jia;WAN Jia-feng;FANG Hui;ZOU Jie;ZHENG Ying;DAI Mei-qin(The 903rd Hospital of Joint Logistic Support Force of PLA,Hangzhou 310013,China;Xixing Street Community Healthcare Center,Hangzhou 310000,China)

机构地区：[1]联勤保障部队第903医院,浙江杭州310013 [2]西兴街道社区卫生服务中心,浙江杭州310000

出　　处：《解放军药学学报》2024年第6期523-526,共4页Pharmaceutical Journal of Chinese People's Liberation Army

摘　　要：目的分析患者在使用万古霉素过程中可能引起急性肾损伤的危险因素。方法根据肾损伤的标准将收集到的病例分为肾毒性组和非肾毒性组,使用χ^(2)检验进行组间比较,分析可能存在的危险因素,进而使用Logistic回归分析对这些因素进行评估。结果纳入本研究的病例中肾毒性组57例,非肾毒性组104例。剂量(P=0.007)、肥胖(身体质量指数≥30,P=0.0104)、年龄(≥80岁,P<0.001)、谷浓度(≥30mg·L^(-1),P=0.0338)、合并心功能不全(P=0.016)、休克(P=0.006)等血流动力学不稳定的基础病以及合并使用大剂量利尿剂(P=0.033),存在统计学差异。多因素Logistic回归分析显示,患者合并休克(OR=11.832)和年龄≥80岁(OR=15.77)影响最大。结论万古霉素致肾功能损伤的发生率较高,对有此风险的患者应给予特别关注。Objective To analyze the risk factors for acute kidney injury in patients using Vancomycin.Methods The collected cases were divided into the acute kidney injury group and non-nephrotoxicity group by the standards for kidney injury.Chi-square test was used for a comparison to identify possible risk factors that were evaluated via logistic regression analysis.Results A total of 57 patients with acute kidney injury and 104 patients without were included in this study.The differences in dosage(P=0.007),levels of obesity(BMI≥30,P=0.0104),age(≥80 years old,P<0.001),trough concentrations(≥30 mg·L^(-1),P=0.0338),complications with cardiac insufficiency(P=0.016),incidence of shock(P=0.006)and other underlying diseases of hemodynamic instability and combined use of high-dose diuretics(P=0.033)were statistically significant.Multivariate logistic regression analysis showed that complications with shock(OR=11.832)and age≥80 years(OR=15.77)made the greatest difference.Conclusion The results show that the incidence of Vancomycin-induced acute kidney injury is high,and special attention should be paid to patients at risk.

关 键 词：万古霉素 肾毒性 LOGISTIC回归分析 

分 类 号：R969.3[医药卫生—药理学]