榄香烯乳状注射液合并用药对肾功能影响的真实世界研究

Real-world analysis on renal impairment of elemene emulsion injection based on propensity score matching

目的:探讨真实世界榄香烯乳状注射液合并用药发生肾功能损伤的主要因素。方法:基于中国中医科学院中医临床基础医学研究所构建的医疗数据库,以全国21家三甲医院中使用过榄香烯乳状注射液的患者信息为研究对象,采用巢式病例对照研究方法,对比肾功能损伤组与对照组患者的合并用药情况,采用MCP变量选择方法筛选可能导致肾功能损伤的主要因素,运用经典Logistic回归及倾向性评分Logistic回归方法进一步分析以上主要因素。结果:分析发现,使用榄香烯乳状注射液前7 d内联合使用氯化钾或使用榄香烯乳状注射液期间联合使用呋塞米可能是导致用药患者发生肾功能损伤的主要因素。结论:榄香烯乳状注射液与上述可能导致肾损伤发生的主要因素应避免联合使用,如若必须使用应加强临床监测,发现异常反应当立即处理,本次研究结果具有一定临床意义,后续可深入进行临床机制的研究与探索。

Objective:To explore the main factors of renal function injury caused by the combination of elemene emulsion injection in the real world.Methods:Based on the hospital information system medical database constructed by the Institute of Clinical Basic Medicine of Chinese Academy of Traditional Chinese Medicine,taking the patient information of elemene emulsion injection used in 21 top three hospitals in China as the research object,the nested case-control study method was used to compare the combined medication of patients with renal function injury group and control group,The main factors that may lead to renal function injury were screened by MCP variable selection method,and the above main factors were further analyzed by classical logistic regression and propensity score logistic regression method.Results:The analysis found that the combined use of potassium chloride within 7 dbefore the use of elemene emulsion injection or the combined use of furosemide during the use of elemene emulsion injection may be the main factor leading to renal function injury.Conclusion:The combination of elemene emulsion injection and the above main factors that may lead to renal injury should be avoided.If it must be used,clinical monitoring should be strengthened,and abnormal reactions should be treated immediately.The results of this study have certain clinical significance,and the clinical mechanism can be further studied and explored in the future.