摘要
目的探讨注射用阿莫西林钠克拉维酸钾致急性肾盂肾炎患者白细胞减少的发生情况和临床特征。方法收集2019年1—12月在香港大学深圳医院肾内科住院期间使用注射用阿莫西林钠克拉维酸钾且用药前白细胞计数(WBC)≥4.0×10^(9)/L的急性肾盂肾炎患者的电子病历,提取患者基本信息、注射用阿莫西林钠克拉维酸钾用药情况、合并用药情况、用药前后血常规检查结果、白细胞减少发生情况以及白细胞减少的干预和转归等,计算白细胞减少发生率,并分析该不良反应的临床特征。白细胞减少定义为WBC<4.0×10^(9)/L(我院WBC参考值下限)。结果纳入分析的患者共134例,注射用阿莫西林钠克拉维酸钾用法均为1.2 g静脉滴注、1次/8 h,其中12例发生白细胞减少,白细胞减少发生率为9.0%。12例患者中,男性1例(8.3%),女性11例(91.7%),年龄(35±12)岁。用药至发生白细胞减少的时间为2~6 d,其中3 d者6例(50.0%)。用药前WBC、中性粒细胞计数和中性粒细胞比例分别为(4.7~17.5)×10^(9)/L、(3.1~15.4)×10^(9)/L和(0.60~0.90),用药后分别降至(2.3~3.9)×10^(9)/L、(0.8~2.4)×10^(9)/L和(0.35~0.65);50.0%(6/12)的患者伴有血红蛋白减少>20 g/L和/或红细胞计数下降>0.5×1012/L。12例患者均无明显临床症状,停药后未给予其他干预,11例WBC恢复正常,1例不详(停药第2天出院后失访)。结论注射用阿莫西林钠克拉维酸钾致急性肾盂肾炎患者白细胞减少的发生率为9.0%,多发生在用药6 d内,一般无明显症状,停药后可恢复,预后良好。
Objective To explore the occurrence and clinical characteristics of leukopenia induced by amoxicillin sodium and clavulanate potassium for injection in patients with acute pyelonephritis.Methods The subjects were patients with acute pyelonephritis who used amoxicillin sodium clavulanate potassium for injection during hospitalization in the Department of Nephrology,the University of Hong Kong‑Shenzhen Hospital from January to December 2019 and had a white blood cell count(WBC)≥4.0×10^(9)/L before amoxicillin sodium clavulanate potassium for injection administration.Cases of leucopenia caused by amoxicillin sodium clavulanate potassium for injection were collected and the patients′basic information,duration of treatment with amoxicillin sodium clavulanate potassium for injection,concomitant medications,blood cell count before and after administration,leukopenia occurrence,and interventions and outcomes of leukopenia were extracted from electronic medical records.The incidence of leucopenia was calculated and the clinical characteristics of the adverse reaction were analyzed.Leukopenia was defined as WBC<4.0×10^(9)/L(lower limit of WBC reference value in our hospital).Results A total of 134 patients were included in the analysis.Of them,12 developed leukopenia,the incidence was 9.0%.Among the 12 patients,1(8.3%)was male and 11(91.7%)were female with an age of(35±12)years.The time from drug administration to the onset of leukopenia ranged from 2 to 6 days and it was 3 days in 6 patients(50.0%).The WBC,neutrophil count,and neutrophil proportion were(4.7~17.5)×10^(9)/L,(3.1~15.4)×10^(9)/L,and(0.60~0.90)before drug administration,and then decreased to(2.3~3.9)×10^(9)/L,(0.8~2.4)×10^(9)/L,and(0.35~0.65)after drug administration,respectively.Fifty percent(6/12)of the patients had hemoglobin decrease>20 g/L and(or)erythro‑cyte count decrease>0.5×1012/L.None of the 12 patients had obvious clinical symptoms,and no other inter‑ventions were given after discontinuation of the drug.WBC returned to normal in 11
作者
王萌萌
张燕妮
吴艾欣
Wang Mengmeng;Zhang Yanni;Wu Aixin(Department of Pharmacy,the University of Hong Kong‑Shenzhen Hospital,Shenzhen 518000,China)
出处
《药物不良反应杂志》
CSCD
2021年第1期20-24,共5页
Adverse Drug Reactions Journal
关键词
阿莫西林克拉维酸钾合剂
白细胞减少
肾盂肾炎
回顾性研究
Amoxicillin‑potassium clavulanate combination
Leukopenia
Pyelonephritis
Retrospective studies
