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替加环素对患者肝功能影响的临床回顾性研究 预览

Retrospective research about effect of tigecycline on liver function
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摘要 目的分析替加环素对患者血清胆红素、肝功能、凝血功能的影响,为合理使用替加环素提供临床依据。方法回顾性分析使用替加环素治疗的175例患者资料,观察患者在使用替加环素注射液后,胆红素、肝功能及凝血功能的变化情况。结果替加环素注射液主要用于肺部感染、腹腔感染、粒缺伴感染的患者。总胆红素(TBIL)、直接胆红素(DBIL)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、碱性磷酸酶(ALP)在替加环素治疗期间最高值及停药后3 d均明显高于治疗当天(t分别=-5.45、-4.48;-4.73、-4.23;-2.68、-2.96;-2.70、-3.21;-4.33、-3.73,P均<0.05),而治疗期间TBIL、DBIL、AST、ALT最高值与停药后3 d无明显差异(t分别=-0.98、-1.03、-0.64、-1.39、-0.51,P均>0.05)。凝血酶原时间(PT)、国际标准化比值(INR)在治疗期间最高值明显高于治疗当天(t分别=-3.79、-2.50,P均<0.05),而停药后3 d PT、INR与治疗当天、治疗期间最高值无明显差异(t分别=-1.48、-1.28;1.53、1.07,P均>0.05)。结论临床使用替加环素应高度警惕高胆红素血症、肝功能异常、凝血功能异常的发生,加强用药监测及指导合理用药,提高用药安全性。 Objective To analyze the effect of tigecycline on serum bilirubin,liver function and coagulation function,so as to provide clinical reference for rational use of tigecycline. Methods Data of 175 patients treated with tigecycline were analyzed retrospectively. The changes of bilirubin,liver function and coagulation function were observed. Results Tigecycline was mainly used in pulmonary infection,abdominal infection and agranulocytosis-associated infection. The highest levels of total bilirubin(TBIL),direct bilirubin(DBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),and alkaline phosphatase(ALP)during treatment and 3 days after withdrawal were higher than those of the day of treatment(t=-5.45,-4.48;-4.73,-4.23;-2.68,-2.96;-2.70,-3.21;-4.33,-3.73,P<0.05),while the differences in TBIL,DBIL,ALT,AST,ALP between the highest levels during treatment and 3 days after withdrawal were not statistically significant(t=-0.98,-1.03,-0.64,-1.39,-0.51,P>0.05).The highest levels of prothrombin time(PT)and international standardization ratio(INR)during treatment were higher than those of the day of treatment(t=-3.79,-2.50,P<0.05).Compared to the day of treatment and the highest levels during the treatment,the PT and INR levels at 3 days after withdrawal had no obvious change(t=-1.48,-1.28;1.53,1.07,P>0.05). Conclusion The occurrence of hyperbilirubinemia,abnormal liver function and coagulation function should be alerted when using tigecycline,and it is necessary to strengthen drug monitoring and guide the rational use of tigecycline.
作者 宋淑萍 徐秋萍 苏伟 杨娜 郭丰 SONG Shuping;XU Qiuping;SU Wei(Department of Intensive Care Unit,Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,Hangzhou 310016,China)
出处 《全科医学临床与教育》 2019年第8期681-684,共4页 Clinical Education of General Practice
基金 浙江省自然科学基金面上项目(Y15H150007).
关键词 替加环素 胆红素 肝功能 凝血功能 tigecycline bilirubin liver function coagulation function
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