哌拉西林他唑巴坦致老年患者急性肾损伤的临床研究

Clinical Study of Acute Kidney Injury Induced by Piperacillin and Tazobactam in Elderly Patients

目的:了解哌拉西林他唑巴坦导致老年患者急性肾损伤(acute kidney injury,AKI)的基本情况,探讨可能增加肾毒性的危险因素。方法:筛选并收集2019—2020年某三级甲等综合性医院使用哌拉西林他唑巴坦静脉滴注治疗感染的老年住院患者资料,采用单中心、回顾性队列研究,对用药前后肌酐等检验数据和主要结果进行统计学分析,最终得出老年患者使用哌拉西林他唑巴坦导致AKI的相关危险因素。结果:共收集2669例老年患者,其中有141例出现AKI,AKI发生率为5.28%,以1级为主。单因素分析结果显示,7个因素与AKI发生有关(P<0.05)。Logistic回归分析结果显示,用药疗程、联合用药、酸碱失衡、贫血及用药合理性为使用哌拉西林他唑巴坦后发生AKI的主要危险因素。结论:医务人员应了解老年患者发生AKI的相关危险因素,采取适当措施,加强用药过程监测,合理用药。

OBJECTIVE:To investigate the basic situation of acute kidney injury(AKI)induced by piperacillin and tazobactam in elderly patients,and explore the risk factors that may increase nephrotoxicity.METHODS:A single-center and retrospective cohort study on elderly patients hospitalized with infection who were given piperacillin and tazobactam intravenous drip treatment in a Grade Ⅲ Level A general hospital from 2019 to 2020 was screened and collected.Statistical analysis was conducted on the data and main outcomes of tests such as creatinine before and after medication,so that the risk factors associated with AKI induced by piperacillin and tazobactam in the elderly were finally derived.RESULTS:A total of 2669 elderly patients were collected,of whom 141 cases developed AKI,with an incidence of 5.28%,with grade one took the lead.Results of univariate analysis showed that 7 factors were associated with AKI(P<0.05).After logistic regression analysis,it was cleared that treatment course,drug combined,acid-base imbalance,anemia and rationality of medication were the main risk factors of the occurrence of AKI after using piperacillin and tazobactam.CONCLUSIONS:Medical staff should understand the risk factors associated with the occurrence of AKI in elderly patients,take appropriate measures to enhance the monitoring of the medication process and rationally.