| 摘要: |
| 目的:研究哌拉西林/ 他唑巴坦致儿童急性肾损伤(AKI)在真实世界的发生率、临床特征及影响因素。 方法:收集 2023 年
1 月至 2024 年 1 月衡水市人民医院、甘肃医学院附属医院使用哌拉西林/ 他唑巴坦患儿的临床资料,分析 AKI 发生率、发生时
间、严重程度和预后。 采用单因素和多因素 logistic 回归分析筛选 AKI 发生的相关影响因素。 结果:共纳入 2 168 例患儿,发生
AKI 75 例,发生率为 3. 46%,年龄≤3 岁患儿发生率最高(4. 78%),>7~18 岁患儿发生率较小(2. 15%);AKI 发生时间为(5. 59±
3. 18)天,年龄≤3 岁患者 AKI 发生时间显著小于>7~18 岁患儿;严重程度以Ⅰ期为主(90. 67%,68 / 75),停药后预后较好,肾功
能恢复时间为(5. 54±1. 72)天。 单因素分析显示,年龄≤3 岁、感染性休克、24 h 液体超负荷、联合用药>3 种、非甾体抗炎药、中
药注射剂、基线血清肌酐清除率(Ccr)低是发生 AKI 的危险因素。 多因素分析显示,年龄≤3 岁(OR = 1. 957)、感染性休克(OR =
2. 322)、24 h 液体超负荷(OR= 5. 023)和联合用药数>3 种(OR = 3. 422)是哌拉西林/ 他唑巴坦致儿童发生 AKI 的独立影响因
素。 结论:哌拉西林/ 他唑巴坦致儿童 AKI 属常见不良反应,早发现、早预防预后较好。 |
| 关键词: 哌拉西林/ 他唑巴坦 儿童 急性肾损伤 临床特征 影响因素 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2025.02.008 |
|
| 基金项目:基金项目:甘肃省教育厅高校教师创新基金项目,编号 2024B-216。 |
|
| Clinical Characteristics and Influencing Factors of Acute Kidney Injury in Children Induced byPiperacillin / Tazobactam |
| Li Guang
1
, Zhang Yuanyuan
1
, Wang Lidan
1
, Wang Weimei
1
, Tuo Mingfu
2
, Zhang Yaling
2 |
| (1. Hengshui People’ s Hospital, Hebei Hengshui 053000, China; 2. Affiliated Hospital of Gansu Medical College, Gansu Pingliang 744000, China) |
| Abstract: |
| Objective: To analyze the incidence, clinical characteristics and influencing factors of acute kidney injury ( AKI) in
children induced by piperacillin / tazobactam in real world. Methods: Clinical data of children receiving piperacillin / tazobactam from
Hengshui People’ s Hospital and Affiliated Hospital of Gansu Medical College from Jan. 2023 to Jan. 2024 were collected. The
incidence, occurrence time, severity and prognosis of AKI were analyzed. Univariate analysis and multivariate logistic regression analysis
were used to screen the influencing factors for AKI. Results: Totally 2,168 children were enrolled, and 75 cases (3. 46%) developed
AKI, the incidence of AKI in children ⩽ 3 years was the highest (4. 78%), and the incidence of AKI in children aged from >7 to 18
years was the lowest (2. 15%). The occurrence time of AKI was (5. 59 ± 3. 18) d, the occurrence time of AKI in children ⩽3 years
was shorter than that in children from >7 to 18 years, the severity of AKI was mainly stage Ⅰ (90. 67% , 68 / 75), the prognosis was
better after drug withdrawal, the recovery time of renal function was (5. 54 ± 1. 72) d. Univariate analysis showed that age ⩽3 years,
septic shock, 24 h fluid overload, drug combination > 3 kinds of drugs, non-steroidal anti-inflammatory drugs, and low baseline serum
creatinine clearance (Ccr) were the risk factors of AKI in children, multivariate analysis showed that age ⩽3 years (OR = 1. 957),
septic shock (OR = 2. 322) , 24 h fluid overload (OR = 5. 023) , and drug combination > 3 kinds of drugs ( OR = 3. 422) were
independent risk factors of AKI in children. Conclusion: AKI induced by piperacillin / tazobactam is a common adverse drug reaction in
children. Early detection and prevention of AKI have better prognosis. |
| Key words: piperacillin / tazobactam children acute kidney injury clinical characteristics influencing factors |
