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利奈唑胺致血小板减少症发生状况及相关影响因素分析研究

王立刚,刘智勇,杜晓明   

  1. 辽宁省检验检测认证中心,辽宁省检验检测认证中心,中国医科大学附属盛京医院
  • 收稿日期:2018-11-30 修回日期:2018-12-19 出版日期:2018-12-25 发布日期:2018-12-25

Analysis of Related Factors Affecting Thrombocytopenia Caused by Linezolid

王立刚, and   

  1. Liaoning Inspection,Examination Certification Center Liaoning Shenyang,Shengjing Hospital of China Medical University#$NBS,Liaoning Shenyang
  • Received:2018-11-30 Revised:2018-12-19 Online:2018-12-25 Published:2018-12-25

摘要: 目的:对使用利奈唑胺的住院患者进行回顾性调查分析,探讨利奈唑胺致相关性血小板减少症的发生情况及其影响因素。方法: 采用回顾性病例研究,对2015年6月至2017年12月某院260例使用利奈唑胺致相关性血小板减少症的发病情况进行分析,采用t检验(参数)和 Mann-Whitney U 检验(非参数),χ2检验逐个分析各指标的组间差异性;采用条件Logistic回归分析不良反应/事件发生的影响因素及其标准回归系数(影响程度)。检验水准α=0.05。结果:纳入研究的260例患者中,有67例发生血小板减少症,发生比例为25.77%。单因素分析年龄分组中>65岁人群中发病率较高,为35.40%(χ2=9.80,P=0.02);≥3个联合用药组中发病率较高,为34.07%(χ2=11.02,P=0.01)。分析表明,实验室检查指标血小板基础值、用药天数、白蛋白、血清肌酐、尿素氮、尿酸与血小板减少症有关(P<0.05)。多因素Logistic回归分析提示:血小板基础值、用药天数、胆红素、肌酐与血小板减少症的发生密切相关。ROC诊断曲线预测分析曲线下面积为0.738,灵敏度68.71%,特异度71.50%,Youden指数0.40。结论:使用利奈唑胺后发生血小板减少症的发生率较高;单因素分析显示应重点关注高龄(≥65岁)、联合用药(≥3种)、基础血小板值低的患者;多因素分析显示,血小板基础值、用药天数、胆红素、肌酐与血小板减少症的发生密切相关。

Abstract: Objective: Retrospective study investigating hospitalized patients using linezolid, to investigate the occurrence and related factors of linezolid-related thrombocytopenia. Methods: Using retrospective case study survey analysis, analysis of patients taking linezolid from June 2015 to December 2017 at Shengjing Hospital of China Medical University, and analysis of the incidence of patient-related thrombocytopenia in 260 patients treated with linezolid. The t-test (parameter) and the Mann-Whitney U test (non-parameter) were used, and the χ2 test was used to analyze the difference between the groups. Conditional logistic regression was used to analyze the influencing factors of adverse reactions/events and their standard regression coefficients (degree of influence).α=0.05. Results: In this study, 67 patients developed thrombocytopenia after the use of linezolid, with an incidence of thrombocytopenia occurrence rate is 25.77% .Univariate analysis showed that the incidence of blood was 35.40% (χ2=9.80) in the age group over 65 years old. The incidence rate of 3 or more combined drug groups was 34.07% (χ2=11.02%). Analysis showed that laboratory indicators, platelet basis values, days of medication, albumin, creatinine, urea, uric acid and thrombocytopenia were associated (P<0.05). Multivariate logistic regression analysis (backward:wald) showed that: platelet basic value, medication days, bile duct. The area under the predictive curve of ROC diagnostic curve was 0.738, sensitivity was 68.71%, specificity was 71.50% and Youden index was 0.40. Conclusion: The incidence of thrombocytopenia after linezolid is high, univariate analysis shows that we should focus on the elderly (≥65 years old), combined therapy (≥3), and basic platelet value. Multivariate analysis showed that platelet basal value, medication days, bilirubin and creatinine were closely related to the occurrence of thrombocytopenia.