基于中国医院药物警戒系统的亚胺培南西司他丁钠相关血小板减少症的危险因素分析

    Risk Factors Analysis of Thrombopenia Related to Imipenem Cilastatin Sodium Based on China Hospital Pharmacovigilance System

    • 摘要:
      目的  基于中国医院药物警戒系统(China Hospital Pharmacovigilance System,CHPS)探讨亚胺培南西司他丁钠相关血小板减少症的危险因素,为临床安全使用亚胺培南西司他丁钠提供参考。
      方法  利用CHPS建立评价方案,选取2017年4月1日—2022年4月1日在河南科技大学附属许昌市中心医院使用亚胺培南西司他丁钠治疗的住院患者。根据使用亚胺培南西司他丁钠后是否出现血小板减少症,将患者分为血小板减少症组和非血小板减少症组,比较2组患者的临床资料,分析亚胺培南西司他丁钠相关血小板减少症的危险因素。
      结果  共有559例患者纳入分析。其中,发生血小板减少症者136例,血小板减少症发生率为24.33%。多因素Logistic回归分析结果显示,碱性磷酸酶、休克、血流感染、入住重症监护室、日剂量和用药时长是亚胺培南西司他丁钠相关血小板减少症的独立危险因素。
      结论 亚胺培南西司他丁钠可引起血小板减少症的发生,临床在使用亚胺培南西司他丁钠过程中,应关注伴有以上危险因素的患者,监测患者血小板计数水平,及时妥善进行临床诊治。

       

      Abstract:
      OBJECTIVE  To explore risk factors of thrombopenia related to imipenem cilastatin sodium based on China Hospital Pharmacovigilance System(CHPS), to provide reference for safely clinical use of imipenem cilastatin sodium.
      METHODS  An evaluation plan was constructed in CHPS to select inpatients treated with imipenem cilastatin sodium in Xuchang Central Hospital Affiliated to Henan University of Science and Technology from Apr 1st, 2017 to Apr 1st, 2022. According to whether thrombopenia had happened, patients were divided into thrombopenia group and non-thrombopenia group. Clinical characteristics between the two groups were compared. The risk factors of thrombopenia related to imipenem cilastatin sodium were analyzed using the multivariable logistic regression model.
      RESULTS  A total of 559 patients were enrolled into this study. Among them, 136 patients developed thrombopenia. The incidence of thrombopenia was 24.33%. Result of multivariate Logistic regression analysis showed that alkaline phosphatase, shock, bloodstream infection, admission to intensive care units, daily dose and treatment course were independent risk factors of thrombopenia related to imipenem cilastatin sodium.
      CONCLUSION Imipenem cilastatin sodium can induce thrombopenia. Attentions should be paid to patients with risk factors mentioned above, and platelet count should be monitored when patients are treated with imipenem cilastatin sodium in order to take timely and proper diagnosis and treatment.

       

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