摘要
目的对比分析万古霉素联用亚胺培南西司他丁或美罗培南发生急性肾损伤的差异,为临床决策提供参考。方法采用回顾性分析方法,将2022年1月至2023年12月在江苏省常州市第一人民医院住院治疗且使用过亚胺培南西司他丁钠或美罗培南联用万古霉素的所有成年患者纳入评估,联合用药时间最少为72 h,主要研究终点是急性肾损伤的发生率,次要终点是急性肾损伤的危险因素。结果共纳入436例患者,其中亚胺培南西司他丁联用万古霉素254例,美罗培南联用万古霉素182例。亚胺培南西司他丁联用万古霉素的急性肾损伤发生率为16.9%,美罗培南联用万古霉素的急性肾损伤发生率为8.2%(P=0.034)。多因素Logistic回归分析显示,联用亚胺培南西司他丁是急性肾损伤的独立危险因素,同时,万古霉素谷浓度每升高1 mg/L,急性肾损伤风险增加8.1%。结论与亚胺培南西司他丁联用万古霉素相比,美罗培南联用万古霉素发生急性肾损伤的风险较低。
Objective To compare the difference in the incidence of acute kidney injury(AKI)between vancomycin combined with imipenem-cilastatin and vancomycin combined with meropenem,so as to provide evi-dence for clinical decision-making.Methods A retrospective analysis was conducted on all adult patients at Changzhou First People’s Hospital,Jiangsu Province,who received either imipenem-cilastatin or meropenem in combination with vancomycin from January 2022 to December 2023.The duration of combined medication was at least 72 hours.The primary endpoint was the incidence of AKI,and the secondary endpoint was the risk factors for AKI.Results A total of 436 patients were included,of whom 254 received imipenem-cilastatin combined with vancomycin and 182 received meropenem combined with vancomycin.The incidence of AKI was 16.9%in the imipenem-cilastatin plus vancomycin group and 8.2%in the meropenem plus vancomycin group(P=0.034).Multivariate logistic regression analysis showed that combination with imipenem-cilastatin was an independent risk factor for acute kidney injury.Additionally,for each 1 mg/L increase in vancomycin trough concentration,the risk of AKI increased by 8.1%.Conclusions Compared with imipenem-cilastatin combined with vancomycin,meropenem combined with vancomycin is associated with a lower risk of AKI.
作者
高航
蒋军
岳家欣
夏宗玲
Gao Hang;Jiang Jun;Yue Jiaxin;Xia Zongling(Department of Pharmacy,Third Affiliated Hospital of Soochow University,First People′s Hospital of Changzhou,Changzhou,Jiangsu 213000,China)
出处
《中国药物与临床》
2026年第3期159-163,共5页
Chinese Remedies & Clinics
基金
江苏省常州市第七批科技计划项目-应用基础研究专项(CJ20242021)。
