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替加环素相关性凝血病:单中心回顾性分析。

Tigecycline-Associated Coagulopathy: A Single-Center Retrospective Analysis.

机构信息

Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Department of Pharmacy, Nanfang Hospital, Southern Medical University, Guangzhou, China.

出版信息

Pharmacology. 2022;107(9-10):524-536. doi: 10.1159/000525380. Epub 2022 Jul 12.

Abstract

INTRODUCTION

The purpose of this study was to assess clinical characteristics and risk factors for tigecycline-associated prothrombin time (PT) and activated partial thromboplastin time (aPTT) prolongation.

METHODS

We performed a retrospective analysis on coagulation parameters before and during tigecycline treatment in 55 patients in our hospital with severe infections, mainly pneumonia caused by Acinetobacter baumannii. Patients were divided into different groups according to prolongation of PT and aPTT, and clinical features involved were explored. Univariate and multivariable binary logistic regression analyses were used to identify risk factors for tigecycline-associated PT and aPTT increase.

RESULTS

We found that PT values increased from 12.73 ± 1.87 to 13.86 ± 2.06 during the treatment compared with premedication (p < 0.001), and the aPTT level prolonged significantly from 33.63 ± 11.24 to 38.15 ± 11.81 (p < 0.001). The multivariate analyses identified 2 variables that were associated with tigecycline-induced PT prolongation: albumin level (p = 0.018) and weight-adjusted tigecycline dosage (p = 0.005). In addition, treatment duration was the only risk factor for tigecycline-induced aPTT prolongation (p = 0.043).

CONCLUSION

Albumin level, weight-adjusted tigecycline dosage, treatment duration may serve as risk indicators for tigecycline-associated coagulation dysfunction. Physicians should be careful with coagulation disorder when prescribing tigecycline in clinical practice, especially in patients with risk factors.

摘要

简介

本研究旨在评估替加环素相关凝血酶原时间(PT)和活化部分凝血活酶时间(aPTT)延长的临床特征和危险因素。

方法

我们对我院 55 例严重感染患者(主要为鲍曼不动杆菌引起的肺炎)使用替加环素治疗前后的凝血参数进行回顾性分析。根据 PT 和 aPTT 延长的情况将患者分为不同组,并探讨涉及的临床特征。采用单因素和多因素二分类逻辑回归分析来确定替加环素相关 PT 和 aPTT 增加的危险因素。

结果

我们发现治疗期间 PT 值从 12.73 ± 1.87 增加到 13.86 ± 2.06(p < 0.001),aPTT 水平显著延长,从 33.63 ± 11.24 增加到 38.15 ± 11.81(p < 0.001)。多因素分析确定了 2 个与替加环素引起的 PT 延长相关的变量:白蛋白水平(p = 0.018)和体重校正的替加环素剂量(p = 0.005)。此外,治疗持续时间是替加环素引起的 aPTT 延长的唯一危险因素(p = 0.043)。

结论

白蛋白水平、体重校正的替加环素剂量、治疗持续时间可能是替加环素相关凝血功能障碍的危险因素。在临床实践中,医生在开具替加环素时应注意凝血障碍,特别是在有危险因素的患者中。

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