哌拉西林钠舒巴坦钠是否根据肌酐清除率调整剂量对慢性肾功能不全患者的影响

Effects of Piperacillin Sodium and Sulbactam Sodium on Patients with Chronic Renal Insufficiency by Adjusting Its Dose According to the Creatinine Clearance Rate

目的探讨哌拉西林钠舒巴坦钠(简称"哌舒")是否根据肌酐清除率(Ccr)调整剂量对慢性肾功能不全患者的影响。方法收集某院2015~2018年符合纳入和排除标准的慢性肾功能不全患者137例,根据患者使用哌舒的剂量和用药前的Ccr分成两组:甲组50例,哌舒的日剂量根据患者用药前的Ccr调整,乙组87例,哌舒的日剂量未根据患者用药前的Ccr调整;分别比较两组患者用药3 d后的肾损伤加重率、用药7 d后的肾损伤加重率和抗感染治疗有效率。结果甲组用药3 d后的肾损伤加重率、用药7 d后的肾损伤加重率、抗感染治疗有效率分别为29.03%、35.29%和76.00%,乙组用药3 d后的肾损伤加重率、用药7 d后的肾损伤加重率、抗感染治疗有效率分别为22.39%、22.58%和78.16%,两组患者各指标差异均无统计学意义(P>0.05)。结论慢性肾功能不全患者使用哌舒是否根据Ccr减量,肾损伤加重率和抗感染治疗有效率均没有明显差异。

OBJECTIVE To investigate Effects of piperacillin sodium and sulbactam sodium on patients with chronic renal insufficiency by adjusting its dose according to the creatinine clearance rate. METHODS A total of 137 patients with chronic renal insufficiency,who met the inclusion and exclusion criteria from 2015 to 2018 was included.They were assigned to group A( 50 cases,whose daily dose of piperacillin sodium and sulbactam sodium was adjusted according to the Ccr before the patient's medication) and group B( 87 cases,whose daily dose of piperacillin sodium and sulbactam sodium wasn't adjusted according to the Ccr before the patient's medication).The rates of patients'with renal injury aggravation after three days' and seven days' medication,and the effective rate of anti-infection treatment were compared between the two groups. RESULTS The rates of patients' with renal injury aggravation after three days' and seven days' medication,and the effective rate of anti-infection treatment in group A were 29. 03%,35. 29%,76.00%,respectively,and were 22.39%,22.58% and 78.16% in group B,respectively.There was no significant difference in the above indicators between the two groups( P > 0. 05). CONCLUSION For patients with chronic renal insufficiency,dose adjustment of piperacillin sodium and sulbactam sodium according to Ccr has no significant effects on both the rate of patients' suffered renal injury aggravation and the effective rate of anti-infection treatment.