摘要
目的观察利奈唑胺治疗期间低钠血症的发生率,并确定其危险因素。方法回顾性分析2017年1月—2019年7月浙江中医药大学附属杭州西溪医院重症医学科152例接受利奈唑胺治疗的住院患者。低钠血症定义为利奈唑胺治疗期间血钠含量≤134 mmol·~L(-1)。通过多元回归分析确定其危险因素。结果28例(23.3%)患者出现低钠血症,其中2例为严重低钠血症(血纳含量≤128mmol·L^L(-1))。单因素和多因素Logistic回归分析表明,应用利奈唑胺前血浆C-反应蛋白(C-reactive protein,CRP)水平(b=0.010,OR=1.019,95%CI 1.005~1.033,P=0.007)以及合并使用脂肪乳氨基酸(18)注射液(b=-1.591,OR=0.151,95%CI 0.034~0.673,P=0.002)是低钠血症发生相关的独立变量。利奈唑胺治疗前,低钠血症组CRP水平显著高于非低钠血症组(t=-2.932,P=0.004)。在联合应用脂肪乳氨基酸(18)注射液的患者中,低钠血症发生的频率明显更高(x^2=20.444,P=0.003)。结论使用利奈唑胺治疗的严重炎症患者和联合使用脂肪乳氨基酸(18)注射液的患者的血浆钠水平应该持续监测。
OBJECTIVE To examine the incidence rate of hyponatremia that developed during linezolid therapy and identify its risk factors.METHODS In this retrospective analysis study,152 hospitalized patients treated with linezolid in intensive critical unit of Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University between January 2017 and July 2019 were analyzed.Hyponatremia was defined as sodium level≤134 mmol·L-1 for the duration of linezolid therapy.Its risk factors were identified via a Logistic regression analysis.RESULTS Hyponatremia occurred in 28(23.3%)patients,and among these it was severe in two cases(sodium level≤128 mmol·L-1).Univariate and multiple Logistic regression analyses identified the plasma C-reactive protein(CRP)level(b=0.010,OR=1.019,95%CI 1.005-1.033,P=0.007)before the initial administration of linezolid and the concomitant use of a fat emulsion and amino acids(18)injection(β=-1.591,OR=0.151,95%CI 0.034-0.673,P=0.002)as the independent variables associated with the development of hyponatremia,respectively.Before linezolid treatment,the CRP levels of the hyponatremia group were significantly higher than those of the no-hyponatremia group(t=-2.932,P=0.004).The frequency of hyponatremia development was significantly higher in the patients who received both the fat emulsion and amino acids(18)injection and linezolid(x2=20.444,P=0.003).CONCLUSION These results suggest that the plasma sodium levels of patients with severe inflammation who are treated with linezolid and those of linezolid-treated patients co-administered a fat emulsion and amino acids(18)injection shall be continuously monitored.
作者
金靓燕
张思泉
刘华锋
赵曦
姚嫣
周可幸
JIN Liangyan;ZHANG Siquan;LIU Huafeng;ZHAO Xi;YAO Yan;ZHOU Kexing(Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University,Department of Pharmacy,Hangzhou 310023,China;Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University,Department of ICU,Hangzhou 310023,China;Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University,Department of Statistics Office,Hangzhou 310023,China)
出处
《中国现代应用药学》
CAS
CSCD
北大核心
2020年第18期2241-2244,共4页
Chinese Journal of Modern Applied Pharmacy
基金
北京医卫健康公益基金会资助项目(TLG17123)。
