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三级医院中替加环素诱导胰腺炎的临床特征及危险因素:一项回顾性研究

Clinical characteristics and risk factors for tigecycline-induced pancreatitis in a tertiary hospital: A retrospective study.

作者信息

Tan Qinghai, Zhang Yu, Liu Mei, Tian De'an, Wu Xiaohui, Zhou Lei, Fan Wenjuan

机构信息

Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

Department of Internal Medicine, Dangyang Changbanpo Hospital, Yichang, Hubei, China.

出版信息

Br J Clin Pharmacol. 2023 Sep;89(9):2788-2797. doi: 10.1111/bcp.15776. Epub 2023 May 22.

Abstract

AIMS

To analyse the clinical characteristics and risk factors for tigecycline-induced pancreatitis (TIP) and evaluate the safety and efficiency of tigecycline use in non-TIP.

METHODS

A retrospective case-control study was conducted on adult and juvenile patients administered tigecycline for >3 days. The adults were classified as TIP, non-TIP (pancreatitis with other causes) and non-pancreatitis. Univariate analyses were performed to compare TIP and non-pancreatitis, and multivariate analysis was used to identify risk factors for TIP. The clinical characteristics of TIP, and the safety and efficiency of tigecycline use in non-TIP were evaluated.

RESULTS

A total of 3910 patients (3823 adults and 87 juveniles) were enrolled. The adult patients comprised 21 TIP, 82 non-TIP and 3720 non-pancreatitis. The TIP prevalence was 0.56% in adults and 1.15% in juveniles. The mean time from tigecycline use to symptom onset was 7.2 days, and all cases were mild pancreatitis. The mean time from tigecycline withdrawal to symptom relief was 3.6 days. The multivariate analysis identified comorbid renal insufficiency as an independent risk factor for TIP (odds ratio = 3.032). Among the 82 non-TIP patients, 81.7% had severe pancreatitis and 47.6% had necrotizing pancreatitis. The modified computed tomography severity score after tigecycline use was similar to that before tigecycline use, but the pancreatic enzymes and infection indices were significantly decreased.

CONCLUSIONS

The prevalence of TIP was low. Comorbid renal insufficiency was as an independent risk factor for TIP. Tigecycline is safe and efficient for treatment of pancreatitis, especially necrotizing pancreatitis, with intra-abdominal infection.

摘要

目的

分析替加环素诱导的胰腺炎(TIP)的临床特征和危险因素,并评估替加环素在非TIP患者中使用的安全性和有效性。

方法

对使用替加环素超过3天的成年和青少年患者进行回顾性病例对照研究。将成年患者分为TIP组、非TIP组(其他原因引起的胰腺炎)和非胰腺炎组。进行单因素分析以比较TIP组和非胰腺炎组,并使用多因素分析确定TIP的危险因素。评估TIP的临床特征以及替加环素在非TIP患者中使用的安全性和有效性。

结果

共纳入3910例患者(3823例成人和87例青少年)。成年患者中,TIP组21例,非TIP组82例,非胰腺炎组3720例。成人TIP患病率为0.56%,青少年为1.15%。从使用替加环素到症状出现的平均时间为7.2天,所有病例均为轻度胰腺炎。从停用替加环素到症状缓解的平均时间为3.6天。多因素分析确定合并肾功能不全是TIP的独立危险因素(比值比=3.032)。在82例非TIP患者中,81.7%为重症胰腺炎,47.6%为坏死性胰腺炎。使用替加环素后的改良计算机断层扫描严重程度评分与使用前相似,但胰腺酶和感染指标显著下降。

结论

TIP的患病率较低。合并肾功能不全是TIP的独立危险因素。替加环素治疗伴有腹腔内感染的胰腺炎,尤其是坏死性胰腺炎,安全有效。

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