Zhang Qian, Zhou Suming, Zhou Jing
Department of Geriatrics Intensive Care Unit, the First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
Department of Geriatrics Intensive Care Unit, the First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China
Antimicrob Agents Chemother. 2015 Mar;59(3):1650-5. doi: 10.1128/AAC.04305-14. Epub 2014 Dec 29.
The objective of this study was to assess the impact of tigecycline treatment on coagulation parameters, specifically fibrinogen, in patients with severe infections. We examined 20 cases of tigecycline-treated patients with severe infections, including hospital-acquired pneumonia, complicated intra-abdominal infections, complicated skin and soft tissue infections, and bloodstream infections. We monitored the relative markers of coagulation and renal and liver function before, during, and after treatment. Fibrinogen (FIB) levels decreased significantly after the use of tigecycline and normalized after the cessation of treatment. FIB levels significantly decreased in the patients treated with the recommended dose or a higher treatment dose. The FIB levels decreased more in the higher-treatment-dose group. There was no difference in the decrease in FIB levels or the FIB level recovery by age. Prothrombin time (PT), activated partial thromboplastin time (APTT), and thrombin time (TT) were prolonged after tigecycline use. The TT decreased after the cessation of treatment, and the PT and APTT also decreased but not to a significant level. There was no change in platelet, alanine aminotransferase (ALT), or creatinine (Cr) levels associated with treatment. The use of tigecycline was associated with decreased FIB levels, which returned to normal after the cessation of treatment. A high-dose treatment group showed greater decreases in FIB levels than did patients treated with the recommended dose. The decline in FIB was not related to patient age. The use of tigecycline was associated with prolonged PT, APTT, and TT.
本研究的目的是评估替加环素治疗对重症感染患者凝血参数，特别是纤维蛋白原的影响。我们检查了20例接受替加环素治疗的重症感染患者，包括医院获得性肺炎、复杂性腹腔内感染、复杂性皮肤和软组织感染以及血流感染。我们在治疗前、治疗期间和治疗后监测了凝血相关指标以及肝肾功能。使用替加环素后纤维蛋白原（FIB）水平显著下降，停药后恢复正常。接受推荐剂量或更高治疗剂量的患者FIB水平显著下降。高治疗剂量组的FIB水平下降幅度更大。FIB水平下降幅度或FIB水平恢复情况在不同年龄患者中无差异。使用替加环素后凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）和凝血酶时间（TT）延长。停药后TT下降，PT和APTT也下降，但未降至显著水平。与治疗相关的血小板、丙氨酸氨基转移酶（ALT）或肌酐（Cr）水平无变化。使用替加环素与FIB水平降低有关，停药后恢复正常。高剂量治疗组的FIB水平下降幅度大于接受推荐剂量治疗的患者。FIB的下降与患者年龄无关。使用替加环素与PT、APTT和TT延长有关。
