摘要
目的 探讨头孢哌酮钠舒巴坦钠致凝血功能异常的危险因素分析。方法 收集经第三代头孢菌素抗生素(头孢哌酮钠舒巴坦钠)治疗的100例患者为研究对象。根据患者是否出现凝血功能异常分为异常组(n=29)和正常组(n=71)。比较2组性别、年龄、体温、脉搏、治疗疗程、白细胞计数(white cell count,WBC)、白蛋白、尿素氮、总胆红素(total bilirubin,TBIL)、降钙素原(procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)、饮食情况、用药剂量、合并基础病等;通过多因素Logistic回归分析明确患者凝血功能异常的危险因素;通过Person系数分析WBC、白蛋白、尿素氮、CRP与凝血酶原时间(prothrombin time,PT)、活化部分凝血酶原时间(activated partial prothrombin time,APTT)的相关性。结果 2组性别、年龄、体温、脉搏、治疗疗程、TBIL、PCT、CRP、合并高血压、合并糖尿病比较差异无统计学意义(P>0.05);异常组白蛋白水平显著低于正常组,WBC、尿素氮、CRP水平、饮食<1 200 mL/d、用药剂量≥3 g/d占比均高于正常组(P<0.05);经ROC分析证实WBC、白蛋白、尿素氮、CPR水平均可用于头孢哌酮钠舒巴坦钠在抗感染过程中凝血功能异常的预测,曲线下面积分别为0.913、0.829、0.920、0.847(P<0.05);经多因素Logistic回归分析证实,饮食<1 200 mL/d、用药剂量≥3 g/d、WBC>11.385×10~9/L、白蛋白<28.815 g/L、尿素氮>14.199μmol/L、CRP>17.629 mg/L是凝血功能异常的危险因素(P<0.05);相关性分析显示,WBC、尿素氮、CPR水平与PT、APTT均呈正相关,白蛋白与PT、APTT呈负相关(P<0.05)。结论 头孢哌酮钠舒巴坦钠在抗感染过程中致凝血功能异常受到诸多因素影响,如较高的WBC、尿素氮、CPR水平,较低的白蛋白水平,较高的用药剂量,较少的饮食等,WBC、尿素氮、CPR水平越高及白蛋白水平越低,患者凝血功能越差。
Objective To explore the risk factors of coagulation dysfunction caused by cefoperazone sodium and sulbactam sodium.Methods A total of 100 patients treated with the third generation cephalosporin antibiotic(cefoperazone sodium and sulbactam sodium) were collected.Patients were divided into abnormal group(n=29) and normal group(n=71) according to presence of abnormal coagulation function.Gender,age,body temperature,pulse,treatment course,white cell count(WBC),albumin,urea nitrogen,total bilirubin(TBIL),procalcitonin(PCT),C-reactive protein(CRP),diet,drug dosage,and combined underlying diseases were compared between two groups.Multivariate Logistic regression analysis was used to identify the risk factors of coagulation dysfunction.The correlations of WBC,albumin,urea nitrogen,CRP,with PT and APTT were analyzed by Person coefficient.Results There was no significant difference in gender,age,body temperature,pulse,treatment course,TBIL,PCT,CRP,combined hypertension and diabetes between two groups(P>0.05).The levels of albumin in abnormal group were significantly lower than those in normal group,while the levels of WBC,urea nitrogen,CRP,diet < 1 200 mL/d,and dosage ≥3 g/d were higher than those in normal group(P<0.05).Receiver operating characteristic(ROC) analysis proved that WBC,albumin,urea nitrogen and CPR levels could be used to predict coagulation dysfunction of cefoperazone sodium and sulbactam sodium during anti-infection process,and the areas under the ROC curve were 0.913,0.829,0.920 and 0.847,respectively(P<0.05).Multivariate Logistic regression analysis confirmed that diet < 1 200 mL/d,dosage ≥3 g/d,WBC > 11.385×10~9/L,albumin < 28.815 g/L,urea nitrogen > 14.199 μmol/L,CRP > 17.629 mg/L were the risk factors for coagulation dysfunction(P<0.05).Correlation analysis showed that WBC,urea nitrogen and CPR levels were positively correlated with PT and APTT,while albumin was negatively correlated with PT and APTT(P<0.05).Conclusion The coagulation dysfunction caused by cefoperazone sodium and sulbactam sodium in anti-infection process is affected by various factors,such as higher WBC,urea nitrogen,CPR level,lower albumin level,higher dosage,and less diet.The higher WBC,urea nitrogen and CPR levels and the lower albumin level,the worse the coagulation function of patients.
作者
崔琼
曹佳淋
崔晓静
杨晓迪
崔红晶
CUI Qiong;CAO Jia-lin;CUI Xiao-jing;YANG Xiao-di;CUI Hong-jing(Departmentof Clinical Laboratory,the Third People′s Hospital of Huizhou City,Guangdong Province,Guangdong Province,Huizhou 516005,China;School of Basic Medicine,Guangdong Medical University,Dongguan 523808,China)
出处
《河北医科大学学报》
CAS
2024年第1期76-81,共6页
Journal of Hebei Medical University
基金
广东省自然科学基金(2019A1515012170)。
关键词
头孢哌酮钠舒巴坦钠
血液凝集障碍
影响因素分析
Cefoperazone sodium and sulbactam sodium
blood coagulation disorders
influencing factor analysis
