肾功能对老年患者中利奈唑胺的血药浓度及血液学毒性的影响：一项倾向匹配队列分析。

Renal function affects the plasma concentration and hematological toxicity of linezolid in elderly patients: a propensity-matched cohort analysis.

作者信息

Liu Bing, Geng Guangrui, Liu Tingting, Zhou Lingli, Wang Fang, Yang Ping, Liu Jiaxin, Zhao Junshuai, Zhao Cheng, Wang Yue, Yang Minna, Fu Jing, Chen Jingyue, Chen Xiaomin, Fang Xiangqun, Xie Lixin, Li Hongxia

机构信息

Department of adult cardiac surgery, Sixth Medical Center of Chinese PLA General Hospital, Beijing, 100853, China.

Department of Critical Care Medicine, 920th Hospital of Joint Logistics Support Force of Chinese PLA, Kunming, Yunnan Province, 650032, China.

出版信息

BMC Geriatr. 2025 Aug 6;25(1):597. doi: 10.1186/s12877-025-06241-9.

DOI:10.1186/s12877-025-06241-9

PMID:40770679

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12330126/

Abstract

BACKGROUND

The relationships of renal function with linezolid trough concentration (C) and hematological toxicity have not been clarified in elderly patients.

METHODS

In this propensity-matched cohort analysis, elderly patients receiving linezolid at four tertiary hospitals in Beijing between May 2021 and March 2024 were included. The patients were grouped by renal function and propensity score matching (PSM) was used to balance baseline characteristics. Linezolid C and hematological indices were monitored dynamically.

RESULTS

Among 320 patients, 152 were eventually enrolled after PSM, including 56 (36.8%) patients with normal renal function (RN) and 96 (63.2%) patients with renal dysfunction (RD). C at 3–5 (12.5 mg/L vs. 21.2 mg/L, = 0.001) and 6–10 days (14.8 mg/L vs. 27.4 mg/L, < 0001) was significantly lower in the RN group. The risk of linezolid-associated thrombocytopenia (LAT) and linezolid-associated anemia (LAA) in the RD group was 4.485 folds and 2.308 folds higher than in the RN group. The decreases in hematological indices were significantly higher in RD group than in RN group.

CONCLUSIONS

Renal function significantly affected linezolid C and hematological toxicity, and the dose of linezolid should be reduced in elderly patients with renal dysfunction.

TRIAL REGISTRATION

ChiCTR2100045707; Registration Date: 23/04/2021.

摘要

背景

老年患者肾功能与利奈唑胺谷浓度（C）及血液学毒性之间的关系尚未明确。

方法

在这项倾向评分匹配队列分析中，纳入了2021年5月至2024年3月期间在北京四家三级医院接受利奈唑胺治疗的老年患者。根据肾功能对患者进行分组，并采用倾向评分匹配（PSM）来平衡基线特征。动态监测利奈唑胺C和血液学指标。

结果

320例患者中，PSM后最终纳入152例，其中肾功能正常（RN）患者56例（36.8%），肾功能不全（RD）患者96例（63.2%）。RN组在第3 - 5天（12.5mg/L对21.2mg/L，P = 0.001）和第6 - 10天（14.8mg/L对27.4mg/L，P < 0.001）的C显著更低。RD组发生利奈唑胺相关性血小板减少症（LAT）和利奈唑胺相关性贫血（LAA）的风险分别比RN组高4.485倍和2.308倍。RD组血液学指标的下降幅度显著高于RN组。