哌拉西林/他唑巴坦致儿童患者急性肾损伤的临床特征及影响因素分析  

Clinical Characteristics and Influencing Factors of Acute Kidney Injury in Children Induced by Piperacillin/Tazobactam

作　　者：李光 张媛媛 王立丹 王伟美 脱鸣富 张亚玲 Li Guang;Zhang Yuanyuan;Wang Lidan;Wang Weimei;Tuo Mingfu;Zhang Yaling(Hengshui People’s Hospital,Hebei Hengshui 053000,China;Affiliated Hospital of Gansu Medical College,Gansu Pingliang 744000,China)

机构地区：[1]衡水市人民医院,河北衡水053000 [2]甘肃医学院附属医院,甘肃平凉744000

出　　处：《儿科药学杂志》2025年第2期36-40,共5页Journal of Pediatric Pharmacy

基　　金：甘肃省教育厅高校教师创新基金项目,编号2024B-216。

摘　　要：目的:研究哌拉西林/他唑巴坦致儿童急性肾损伤(AKI)在真实世界的发生率、临床特征及影响因素。方法:收集2023年1月至2024年1月衡水市人民医院、甘肃医学院附属医院使用哌拉西林/他唑巴坦患儿的临床资料,分析AKI发生率、发生时间、严重程度和预后。采用单因素和多因素logistic回归分析筛选AKI发生的相关影响因素。结果:共纳入2168例患儿,发生AKI 75例,发生率为3.46%,年龄≤3岁患儿发生率最高(4.78%),>7~18岁患儿发生率较小(2.15%);AKI发生时间为(5.59±3.18)天,年龄≤3岁患者AKI发生时间显著小于>7~18岁患儿;严重程度以Ⅰ期为主(90.67%,68/75),停药后预后较好,肾功能恢复时间为(5.54±1.72)天。单因素分析显示,年龄≤3岁、感染性休克、24 h液体超负荷、联合用药>3种、非甾体抗炎药、中药注射剂、基线血清肌酐清除率(Ccr)低是发生AKI的危险因素。多因素分析显示,年龄≤3岁(OR=1.957)、感染性休克(OR=2.322)、24 h液体超负荷(OR=5.023)和联合用药数>3种(OR=3.422)是哌拉西林/他唑巴坦致儿童发生AKI的独立影响因素。结论:哌拉西林/他唑巴坦致儿童AKI属常见不良反应,早发现、早预防预后较好。Objective:To analyze the incidence,clinical characteristics and influencing factors of acute kidney injury(AKI)in children induced by piperacillin/tazobactam in real world.Methods:Clinical data of children receiving piperacillin/tazobactam from Hengshui People’s Hospital and Affiliated Hospital of Gansu Medical College from Jan.2023 to Jan.2024 were collected.The incidence,occurrence time,severity and prognosis of AKI were analyzed.Univariate analysis and multivariate logistic regression analysis were used to screen the influencing factors for AKI.Results:Totally 2,168 children were enrolled,and 75 cases(3.46%)developed AKI,the incidence of AKI in children≤3 years was the highest(4.78%),and the incidence of AKI in children aged from>7 to 18 years was the lowest(2.15%).The occurrence time of AKI was(5.59±3.18)d,the occurrence time of AKI in children≤3 years was shorter than that in children from>7 to 18 years,the severity of AKI was mainly stageⅠ(90.67%,68/75),the prognosis was better after drug withdrawal,the recovery time of renal function was(5.54±1.72)d.Univariate analysis showed that age≤3 years,septic shock,24 h fluid overload,drug combination>3 kinds of drugs,non-steroidal anti-inflammatory drugs,and low baseline serum creatinine clearance(Ccr)were the risk factors of AKI in children,multivariate analysis showed that age≤3 years(OR=1.957),septic shock(OR=2.322),24 h fluid overload(OR=5.023),and drug combination>3 kinds of drugs(OR=3.422)were independent risk factors of AKI in children.Conclusion:AKI induced by piperacillin/tazobactam is a common adverse drug reaction in children.Early detection and prevention of AKI have better prognosis.

关 键 词：哌拉西林/他唑巴坦 儿童 急性肾损伤 临床特征 影响因素 

分 类 号：R725.9[医药卫生—儿科]