利奈唑胺致血小板减少症的相关影响因素分析

Analysis of Related Factors Affecting Thrombocytopenia Caused by Linezolid

目的:对使用利奈唑胺的住院患者进行回顾性调查分析,探讨利奈唑胺致相关性血小板减少症的发生情况及其影响因素。方法:采用回顾性病例研究,对2015年6月至2017年12月某院260例使用利奈唑胺致相关性血小板减少症的发病情况进行分析,采用t检验(参数)和Mann-Whitney U检验(非参数),χ~2检验逐个分析各指标的组间差异性;采用条件Logistic回归分析不良反应/事件发生的影响因素及其标准回归系数(影响程度)。检验水准α=0. 05。结果:纳入研究的260例患者中,有67例发生血小板减少症,发生比例为25. 77%。单因素分析年龄分组中> 65岁人群中发病率较高,为35. 40%(χ~2=9. 80,P=0. 02);≥3个联合用药组中发病率较高,为34. 07%(χ~2=11. 02,P=0. 01)。分析表明,实验室检查指标血小板基础值、用药天数、白蛋白、血清肌酐、尿素氮、尿酸与血小板减少症有关(P <0. 05)。多因素Logistic回归分析提示:血小板基础值、用药天数、胆红素、肌酐与血小板减少症的发生密切相关。ROC诊断曲线预测分析曲线下面积为0. 738,灵敏度68. 71%,特异度71. 50%,Youden指数0. 40。结论:使用利奈唑胺后发生血小板减少症的发生率较高;单因素分析显示应重点关注高龄(≥65岁)、联合用药(≥3种)、基础血小板值低的患者;多因素分析显示,血小板基础值、用药天数、胆红素、肌酐与血小板减少症的发生密切相关。

Objective:Retrospective study investigating hospitalized patients using linezolid,to investigate the occurrence and related factors of linezolid-related thrombocytopenia.Methods:Using retrospective case study survey analysis,analysis of patients taking linezolid from June 2015 to December 2017 at Shengjing Hospital of China Medical University,and analysis of the incidence of patient-related thrombocytopenia in 260 patients treated with linezolid.The t-test(parameter)and the Mann-Whitney U test(non-parameter)were used,and theχ^2 test was used to analyze the difference between the groups.Conditional logistic regression was used to analyze the influencing factors of adverse reactions/events and their standard regression coefficients(degree of influence).α=0.05.Results:In this study,67 patients developed thrombocytopenia after the use of linezolid,with an incidence of thrombocytopenia occurrence rate is 25.77%.Univariate analysis showed that the incidence of blood was 35.40%(χ^2=9.80)in the age group over 65 years old.The incidence rate of 3 or more combined drug groups was 34.07%(χ^2=11.02%).Analysis showed that laboratory indicators,platelet basis values,days of medication,albumin,creatinine,urea,uric acid and thrombocytopenia were associated(P<0.05).Multivariate logistic regression analysis(backward:wald)showed that:platelet basic value,medication days,bile duct.The area under the predictive curve of ROC diagnostic curve was 0.738,sensitivity was 68.71%,specificity was 71.50%and Youden index was 0.40.Conclusion:The incidence of thrombocytopenia after linezolid is high,univariate analysis shows that we should focus on the elderly(≥65 years old),combined therapy(≥3),and basic platelet value.Multivariate analysis showed that platelet basal value,medication days,bilirubin and creatinine were closely related to the occurrence of thrombocytopenia.