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替加环素治疗对重症患者凝血功能的影响
引用本文:徐银丽,祁慧,江翊国,梁培.替加环素治疗对重症患者凝血功能的影响[J].中国药物应用与监测,2020(1):6-9.
作者姓名:徐银丽  祁慧  江翊国  梁培
作者单位:南京医科大学附属苏州科技城医院药学部;南京鼓楼医院重症医学科;南京鼓楼医院药学部
基金项目:苏州市2016年度产业技术创新专项(SYSD2016156)
摘    要:目的:研究重症患者静脉使用替加环素对凝血功能的影响。方法:采用回顾性研究方法,提取2017年1月至2018年6月某院ICU使用替加环素静脉治疗的重症患者数据,按照替加环素剂量分为低剂量组和高剂量组,测定患者用药前、用药过程中、停药后的凝血指标。收集患者年龄、感染部位、肝肾功能情况、病原学培养结果等指标并分析。结果:替加环素可显著延长PT、APTT及TT,显著降低FBG、PLT水平(P=0.015、0.027、0.001、0.003、0),高剂量组APTT(P=0.024)、死亡率、出血率、输血率均高于低剂量组。替加环素剂量、用药前基础凝血功能水平可显著影响用药疗程中的凝血功能(P<0.05)。结论:替加环素可显著影响患者凝血功能,可能增加出血风险,使用时需监测患者凝血功能变化。

关 键 词:替加环素  凝血功能  重症患者  脓毒血症

Influence of tigecycline on coagulation function in critically ill patients
Authors:XU Yin-li  QI Hui  JIANG Yi-guo  LIANG Pei
Institution:(Department of Pharmacy,the Affiliated Suzhou Science&Technology Town Hospital of Nanjing Medical University,Suzhou 215153,China;Intensive Care Unit,Nanjing Drum Tower Hospital,Nanjing 210008,China;Department of Pharmacy,Nanjing Drum Tower Hospital,Nanjing 210008,China)
Abstract:Objective:To study the influence of tigecycline on coagulation function in critically ill patients.Methods:The data of severe patients treated with tigecycline in intensive care unit from January 2017 to June 2018 were collected by retrospective study.According to the dosage of tigecycline,the patients were divided into low-dose and high-dose groups.The indexes of coagulation were determined before,during and after the administration of tigecycline.The indexes were collected and analyzed such as the age,infection site,liver and kidney function,the results of pathogen culture and so on.Results:Tigecycline could significantly increase the levels of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),and decrease the levels of fibrinogen(FBG),platelet(PLT)(P=0.015,0.027,0.001,0.003,0).The mean of APTT(P=0.024),mortality,the rate of bleeding and blood transfusion in high-dose group were all higher than those of low-dose group.The coagulation function of critically ill patients could be significantly influenced by the dose of tigecycline and the basic level of coagulation function before administration(P<0.05).Conclusion:The risk of bleeding increased due to the significant impacts of tigecycline on coagulation function of critically ill patients.Coagulation index should be monitored during the treatment of tigecycline.
Keywords:Tigecycline  Coagulation function  Critically ill patient  Sepsis
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