系统评价多粘菌素B致成人重症感染患者发生急性肾损伤的危险因素  

Systematic evaluation of risk factors for polymyxin B-associated acute kidney injury in adult patients

作　　者：谭瑞娟 马红芳 张晓燕 王立丹 陈赫军 张媛媛 孟佳 野雪静 杜梅 TAN Ruijuan;MA Hongfang;ZHANG Xiaoyan;WANG Lidan;CHEN Hejun;ZHANG Yuanyuan;MENG Jia;YE Xuejing;DU Mei(Department of Pharmacy,Hengshui People's Hospital,Hebei Hengshui 053000,China;Department of ICU,Hengshui People's Hospital,Hebei Hengshui 053000,China)

机构地区：[1]衡水市人民医院药学部,河北衡水053000 [2]衡水市人民医院重症医学科,河北衡水053000

出　　处：《中国医院药学杂志》2025年第6期688-694,700,共8页Chinese Journal of Hospital Pharmacy

基　　金：河北省2025年度医学科学研究课题(No:20251606)。

摘　　要：目的:系统评价多粘菌素B致成人重症感染患者发生急性肾损伤(acute kidney injury,AKI)的危险因素。方法:检索国内外专业学术期刊在2000年1月至2024年2月公开收录的多粘菌素B致成人患者发生AKI的临床研究,提取有效数据后采用RevMan 5.3软件进行统计学评价。结果:共纳入15篇文献,2215例患者。经统计学检验显示,多粘菌素B致AKI的危险因素包括年龄(OR=1.02,95%CI:1.01~1.03)、入住ICU(OR=2.17,95%CI:1.49~3.15)、恶性肿瘤(OR=4.97,95%CI:1.69~14.67)、低蛋白血症(OR=4.69,95%CI:1.95~11.29)、万古霉素(OR=1.93,95%CI:1.52~2.44)、血管活性药物(OR=2.06,95%CI:1.59~2.67)、髓袢利尿剂(OR=1.30,95%CI:1.01~1.67)、多粘菌素B日剂量(OR=1.59,95%CI:1.27~2.00)。结论:老年人、入住ICU、恶性肿瘤、低蛋白血症、联用万古霉素、血管活性药物、髓袢利尿剂和日剂量(>150 mg)的患者容易发生急性肾损伤。OBJECTIVE To systematically evaluate the risk factors for polymyxin B-associated acute kidney injury(AKI)in adult patients.METHODS The clinical studies on polymyxin B-associated AKI in adult patients published in domestic and foreign academic journals from January 2000 to February 2024 were retrieved.Data were extracted and statistical evaluation was performed by RevMan 5.3 software.RESULTS A total of 15 articles representing 2215 patients were included.Statistical analysis showed that risk factors for polymyxin B-associated AKI included age(OR=1.02,95%CI:1.01-1.03),ICU stay(OR=2.17,95%CI:1.49-3.15),malignancy(OR=4.97,95%CI:1.69-14.67),hypoalbuminemia(OR=4.69,95%CI:1.95-11.29),vancomycin(OR=1.93,95%CI:1.52-2.44),vasoactive drugs(OR=2.06,95%CI:1.59-2.67),loop diuretics(OR=1.30,95%CI:1.01-1.67)and daily dose of polymyxin B(OR=1.59,95%CI:1.27-2.00).CONCLUSION Elderly patients,ICU stay,malignancy,hypoalbuminemia,vancomycin,vasoactive drugs,loop diuretics,and daily dose of polymyxin B(>150 mg)are susceptible to AKI.

关 键 词：多粘菌素B 急性肾损伤 肾毒性 重症感染患者 META分析 

分 类 号：R978.1[医药卫生—药品]