Leng Bing, Xue Yuan Chao, Zhang Wen, Gao Tian Tian, Yan Gen Quan, Tang Hui
Department of Pharmacy, Shandong Provincial Hospital Affiliated to Shandong University.
Centre for Heart Lung Innovation, St. Paul's Hospital and Department of Pathology and Laboratory Medicine, University of British Columbia.
Chem Pharm Bull (Tokyo). 2019;67(3):258-264. doi: 10.1248/cpb.c18-00844.
A number of clinical trials demonstrated that tigecycline was effective and well tolerated in the treatment of patients with various bacterial infections, but few literatures had shown the coagulopathy induced by tigecycline. To address this concern, we performed a retrospective analysis to assess the impact of tigecycline treatment on coagulation parameters in 50 patients with bacterial infections in our hospital (Shandong Provincial Hospital, China). These patients were treated with tigecycline at Shandong Provincial Hospital in 2015-2016 at either a recommended (50 mg q12h) or a higher dose (100 mg q12h). Coagulation parameters, including Fibrinogen (FIB) levels, prothrombin time (PT), activated partial thromboplastin time (aPTT), platelet count (PLT) and D-dimer, were evaluated in order to assess the impact of tigecycline treatment in these severely infected patients. What we found was that the plasma fibrinogen (FIB) level was 4.63 ± 1.56 g/L before tigecycline treatment, and decreased to 2.92 ± 1.23 g/L during treatment, which was statistically significant (p < 0.001). The mean values of aPTT and PT were significantly increased from 39.58 ± 8.72 to 44.05 ± 10.45 s (p = 0.002), and from 15.37 ± 1.53 to 16.37 ± 2.64 s (p = 0.004), respectively. This study demonstrates that treatment of tigecycline could reduce FIB, prolong aPTT and PT. In conclusion, we advise that it is necessary for practitioners routinely monitor coagulation level in at-rick patient populations treated with tigecycline.
多项临床试验表明，替加环素在治疗各种细菌感染患者方面有效且耐受性良好，但很少有文献显示替加环素可诱发凝血病。为解决这一问题，我们进行了一项回顾性分析，以评估替加环素治疗对我院（中国山东省立医院）50例细菌感染患者凝血参数的影响。这些患者于2015 - 2016年在山东省立医院接受替加环素治疗，剂量为推荐剂量（50mg每12小时一次）或更高剂量（100mg每12小时一次）。评估了包括纤维蛋白原（FIB）水平、凝血酶原时间（PT）、活化部分凝血活酶时间（aPTT）、血小板计数（PLT）和D - 二聚体在内的凝血参数，以评估替加环素治疗对这些严重感染患者的影响。我们发现，替加环素治疗前血浆纤维蛋白原（FIB）水平为4.63±1.56g/L，治疗期间降至2.92±1.23g/L，差异有统计学意义（p＜0.001）。aPTT和PT的平均值分别从39.58±8.72显著增加至44.05±10.45秒（p = 0.002），以及从15.37±1.53增加至16.37±2.64秒（p = 0.004）。本研究表明，替加环素治疗可降低FIB水平，延长aPTT和PT。总之，我们建议临床医生有必要对接受替加环素治疗的高危患者常规监测凝血水平。
