替加环素对凝血功能影响的回顾性分析

Retrospective Analysis on Effect of Tigecycline on Coagulation Function

目的:探讨替加环素对患者凝血功能及肝功能的影响。方法:收集2019年1月至2022年6月首都医科大学附属北京友谊医院55例使用替加环素抗感染治疗患者的临床资料,记录患者用药前(T_(0))、用药7 d(T_(7))和用药结束时(T_(f))的凝血功能指标水平,包括外周血纤维蛋白原(FIB)、活化部分凝血酶时间(APTT)、国际标准化比值(INR)、D-二聚体(D-Dimer)和血小板计数(PLT);记录患者T_(0)、T_(7)和T_(f)的肝功能指标水平,包括丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)和白蛋白(ALB);对凝血功能和肝功能指标进行统计学分析。结果:使用替加环素治疗后,患者的FIB水平呈逐渐降低趋势,T_(7)、T_(f)的FIB水平低于T_(0),差异均有统计学意义(P<0.05);APTT延长,T_(7)、T_(f)的APTT长于T_(0),差异均有统计学意义(P<0.05);D-Dimer水平呈降低趋势,T_(f)的D-Dimer水平低于T_(0),差异有统计学意义(P<0.05),提示替加环素对凝血功能有影响。使用替加环素治疗后,患者的T_(7)、T_(f)的ALT水平低于T_(0),差异有统计学意义(P<0.05),呈降低趋势;T_(7)、T_(f)的ALP、AST、TBIL和ALB水平与T_(0)比较,差异均无统计学意义(P>0.05),提示替加环素对肝功能无影响。结论:替加环素可引起FIB水平降低、APTT延长、D-Dimer水平降低,用药期间需严密监测患者的凝血功能,预防出血。

OBJECTIVE:To explore the effects of tigecycline on coagulation function and liver function.METHODS:Clinical data of 55 patients receiving anti-infective treatment with tigacycline in Beijing Friendship Hospital,Capital Medical University from Jan.2019 to Jun.2022 were collected.Levels of coagulation function indicators including peripheral blood fibrinogen(FIB),activated partial thrombin time(APTT),international normalized ratio(INR),D-dimer and platelet count(PLT)were recordedbefore medication(T_(0)),7 d after medication(T_(7))and at the end of medication(T_(f)).The levels of liver function indicators in T_(0),T_(7) and T_(f) were recorded,including alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)and albumin(ALB).The coagulation function and liver function indicators were statistically analyzed.RESULTS:After treatment with tigecycline,the FIB level of patients showed a decreasing trend,and the FIB level of T_(7) and T_(f) was lower than that of T_(0),with statistically significant difference(P<0.05);the APTT of T_(7) and T_(f) was longer than that of T_(0),the difference was statistically significant(P<0.05);the D-dimer level showed a decreasing trend,and the D-dimer level of T_(f) was lower than that of T_(0),with statistically significant difference(P<0.05),suggesting that tigecycline had some effects on coagulation function.After treatment with tigecycline,ALT levels of T_(7) and T_(f) were lower than those of T_(0),the difference was statistically significant(P<0.05),showing a decreasing trend;the levels of ALP,AST,TBIL and ALB in T_(7) and T_(f) were not significantly different from those in T_(0),without statistically significant differences(P>0.05),suggesting that tigecycline had no effect on liver function.CONCLUSIONS:Tigecycline may cause a decrease in FIB levels,prolongation of APTT,and a decrease in D-dimer levels,and patients’coagulation needs to be closely monitored during administration to prevent bleeding.