头孢哌酮/舒巴坦致神经外科患者凝血功能异常的特征及其风险因素
Characteristics and risk factors of cefoperazone/sulbactam related coagulation dysfunc-tion in neurosurgery patients
金星 1路晓芸 1李亚美2
作者信息
- 1. 710032 西安,空军军医大学西京医院疾病预防控制科
- 2. 710002,西安市第一医院药学部
- 折叠
摘要
目的 探讨神经外科患者发生头孢哌酮/舒巴坦相关性凝血功能异常的特征及其风险因素.方法 回顾性分析 2020-01 至 2023-02 空军军医大学西京医院神经外科使用头孢哌酮/舒巴坦的病例资料,根据用药后是否发生凝血功能异常分为正常组与异常组.通过LASSO回归筛选凝血功能异常的风险因素,构建预测模型.结果 共入选病例 108 例,其中用药后凝血功能异常 43 例(39.81%),凝血功能正常 65 例(60.19%).头孢哌酮/舒巴坦相关性凝血功能异常,表现为凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)延长,凝血酶原活动度(PTA)降低,国际标准化比值(INR)升高的特征性变化,其中PT、PTA、INR易受影响,变化幅度大,可作为风险识别的敏感指标.用药后凝血功能异常风险与APACHEⅡ评分(OR=1.133,95%CI:1.039～1.234)、年龄(OR=1.024,95%CI:0.993～1.054)正相关,与 PTA(OR=0.959,95%CI:0.929～0.989)负相关.结论 利用诺模图进行风险评估识别高危人群,加强PT、PTA及APTT等特征性指标的监测,可减少风险事件发生.
Abstract
Objective To analyze the characteristics and risk factors of cefoperazone/sulbactam related coagulation dysfunc-tion in neurosurgery patients.Methods A retrospective study was carried out on the neurosurgery patients treated with cefoperazone/sulbactam in the Neurosurgery Department of Xijing Hospital of Air Force Military Medical University from January 2020 to February 2023.The patients were divided into normal group and abnormal group according to whether there was coagulation dysfunction after medication.The risk prediction model was established based on relevant risk factors screened with LASSO regression.Results A total of 108 patients were involved,including 43 cases(39.81%)with abnormal coagulation dysfunction and 65 cases(60.19%)with nor-mal coagulation function.Cefoperazone/sulbactam related coagulation dysfunction was characterized by prolonged PT and APTT,de-creased PTA and increased INR.PT,PTA and INR were susceptible to cefoperazone/sulbactam and changed significantly,which could be used as sensitive indicators for risk identification.The risk of coagulation dysfunction after medication was positively correlated with APACHE Ⅱ score(OR=1.133,95%CI:1.039-1.234),age(OR=1.024,95%CI:0.993-1.054),and negatively correla-ted with PTA(OR=0.959,95%CI:0.929-0.989).Conclusions The use of nomogram for risk assessment to identify high-risk groups and strengthen the monitoring of PT,PTA,and APTT can reduce the occurrence of risk events.
关键词
头孢哌酮/舒巴坦/凝血功能异常/风险因素/LASSO回归/诺模图Key words
cefoperazone/sulbactam/coagulation dysfunction/risk factors/LASSO regression/nomogram引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据