万古霉素相关急性肾功能损伤危险因素分析
Risk Factors for Vancomycin-related Acute Renal Injury
汪佳 1万佳锋 2方慧 1邹杰 1郑英 1戴美琴1
作者信息
- 1. 310013 浙江杭州,联勤保障部队第903医院
- 2. 310000 浙江杭州,西兴街道社区卫生服务中心
- 折叠
摘要
目的 分析患者在使用万古霉素过程中可能引起急性肾损伤的危险因素.方法 根据肾损伤的标准将收集到的病例分为肾毒性组和非肾毒性组,使用χ2 检验进行组间比较,分析可能存在的危险因素,进而使用Logistic回归分析对这些因素进行评估.结果 纳入本研究的病例中肾毒性组57例,非肾毒性组104例.剂量(P=0.007)、肥胖(身体质量指数≥30,P=0.010 4)、年龄(≥80岁,P<0.001)、谷浓度(≥30 mg·L-1,P=0.033 8)、合并心功能不全(P=0.016)、休克(P=0.006)等血流动力学不稳定的基础病以及合并使用大剂量利尿剂(P=0.033),存在统计学差异.多因素Logistic回归分析显示,患者合并休克(OR=11.832)和年龄≥80岁(OR=15.77)影响最大.结论 万古霉素致肾功能损伤的发生率较高,对有此风险的患者应给予特别关注.
Abstract
Objective To analyze the risk factors for acute kidney injury in patients using Vancomy-cin.Methods The collected cases were divided into the acute kidney injury group and non-nephrotoxicity group by the standards for kidney injury.Chi-square test was used for a comparison to identify possible risk factors that were evaluated via logistic regression analysis.Results A total of 57 patients with acute kidney injury and 104 patients without were included in this study.The differences in dosage(P=0.007),levels of obesity(BMI≥30,P=0.010 4),age(≥80 years old,P<0.001),trough concentrations(≥30 mg·L-1,P=0.033 8),complications with cardiac insufficiency(P=0.016),incidence of shock(P=0.006)and other underlying diseases of hemodynamic instability and combined use of high-dose diuretics(P=0.033)were statistically significant.Multivariate logistic regression analysis showed that complications with shock(OR=11.832)and age≥80 years(OR=15.77)made the greatest difference.Conclusion The results show that the incidence of Vancomycin-induced acute kidney injury is high,and special attention should be paid to patients at risk.
关键词
万古霉素/肾毒性/Logistic回归分析Key words
Vancomycin/nephrotoxicity/Logistic regression analysis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据