异甘草酸镁注射液致低钾血症的危险因素及风险预测模型

Risk factors and risk prediction model of hypokalemia induced by magnesium isoglycyrrhizinate injection

目的探讨异甘草酸镁注射液致低钾血症的危险因素并构建低钾血症风险预测模型,促进异甘草酸镁注射液的临床安全使用。方法采用回顾性研究方法,收集2023年2至8月在医院住院并使用异甘草酸镁注射液患者的资料。以血清钾浓度<3.5mmol·L^(-1)为低钾血症的诊断依据。采用单因素及Logistic二元回归法分析可能引起低钾血症的危险因素,并构建低钾血症的风险预测模型;采用受试者操作特征(ROC)曲线对各风险因素以及联合预测因子进行效能评价。结果共纳入住院患者300例,其中发生低钾血症的有74例,低钾血症发生率为24.67%。单因素分析显示,年龄、性别、单次剂量、患有肿瘤、合并使用排钾利尿药及抗菌药物的患者可能使低钾血症不良反应风险增加(P<0.05)。多因素Logistic回归分析结果显示,患者的性别、年龄、合并使用抗菌药物对患者血清钾水平具有显著性影响(P<0.05)。低钾血症风险预测模型:Y=0.972×X性别+0.031×X年龄+0.813×X合并使用抗菌药物-4.700,ROC曲线的AUC值为0.714。年龄因素的约登指数为0.232,年龄值为62.5岁。结论女性合并使用抗菌药物尤其是年龄62.5岁以上的患者在使用异甘草酸镁注射液前应充分评估血钾情况,若发生低钾血症应及时予以纠正,提高临床用药的安全性。

AIM To investigate the risk factors of hypokalemia induced by magnesium isoglycyrrhizinate injection and establish a hypokalemia risk prediction model,so as to promote the safe use of magnesium isoglycyrrhizinate injection.METHODS The data of patients hospitalized from February to August 2023 who were receiving magnesium lsoglycyrrhizinate injections were collected by retrospective study.The diagnosis of hypokalemia was based on serum potassium concentration<3.5 mmol·L^(-1).A risk prediction model for hypokalemia was developed by analyzing potential risk factors using both univariate analysis and Logistic regression.Receiver operating characteristic(ROC)curves were used to evaluate the efficacy of each risk factor and the co-predictors.RES-ULTS A total of 300 hospitalized patients were included,among which 74 had hypokalemia,the incidence of hypokalemia was 24.67%.Univariate analysis showed that age,sex,single dose,tumor,and combined use of potassium diuretics and antibiotics increased the risk of adverse reactions of hypokalemia(P<0.05).Multivariate Logistic regression analysis showed that gender,age and combined use of antibiotics had significant effects on serum potassium level(P<0.05).The hypokalemia risk prediction model equation was established as Y=0.972×X_(sex)+0.031×X_(age)+0.813×X_(combined use of antibiotics)-4.700,with the AUC value of 0.714 for the ROC curve.The Yoden index for age was 0.232,at the age of 62.5 years.CONCLUSION A full evaluation of blood potassium levels should be conducted for female patients who are using antibiotics in combination,particularly for those over 62.5years old,prior to the administration of magnesium isoglycyrrhizinate injection.If hypokalemia arises,timely correction is necessary to enhance the safety profile of clinical medication.