头孢哌酮钠舒巴坦钠致凝血功能异常的临床特征和相关因素分析

Clinical Features and Risk Factors of Coagulation Disorders Caused by Cefoperazone Sodium and Sulbactam Sodium

目的分析头孢哌酮钠舒巴坦钠引起凝血功能异常的临床特征和影响因素,为合理使用头孢哌酮钠舒巴坦钠提供依据。方法对北京医院2013年1月~2019年12月使用头孢哌酮钠舒巴坦钠治疗细菌感染≥3 d的住院患者进行研究。结果本研究共纳入患者3259例,其中136例患者应用头孢哌酮钠舒巴坦钠后出现了凝血功能异常的药物不良反应,用药后凝血异常出现的时间为3~15 d,平均6.59±3.24 d,主要表现为凝血指标异常和出血,其中有99.3%(135/136)的例患者不良反应分级为1~3级。多因素Logistic回归分析结果显示,头孢哌酮钠舒巴坦钠引起凝血功能异常的独立危险因素(P<0.05)为剂量≥95 mg·kg^(-1)、用药疗程≥9 d、肝肾功能异常以及无法正常进食。结论头孢哌酮钠舒巴坦钠可引起患者凝血功能异常,且中度不良反应发生率较高。对于同时具有两种以上高危因素的患者,本研究建议预防性应用维生素K或者选择其他对凝血功能影响较小的抗菌药物。

OBJECTIVE To find the clinical characteristics and risk factors of coagulation disorders induced by cefoperazone sodium and sulbactam sodium,and provide a basis for rational use of cefoperazone sodium and sulbactam sodium.METHODS A retrospective study was conducted on patients who received cefoperazone sodium and sulbactam sodium from January 2013 to December 2019.The whole therapeutic process was recorded.RESULTS A total of unique 3259 patients were enrolled in this study,136 patients experienced coagulation disorder.Coagulation disorders developed 3-15 days after medication,with an average of(6.59±3.24)days,99.3%(135/136)of the patients had Grade 1-3 adverse reactions.Multivariate logistic regression analysis showed that dose≥95 mg·kg^(-1),treatment course≥9 days,liver and kidney dysfunction and food intake deficiency were the independent risk factors for coagulation disorders caused by cefoperazone sodium and sulbactam sodium(P<0.05).CONCLUSION Cefoperazone sodium and sulbactam sodium can cause coagulation disorders,and the incidence of moderate adverse reactions is high.For patients underlying more than two risk factors,it is recommended to use vitamin K prophylacticly or choose other antibiotics with less impact on coagulation function.