替加环素致低纤维蛋白原血症的危险因素的系统评价
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篇名: 替加环素致低纤维蛋白原血症的危险因素的系统评价
TITLE: Risk factors for tigecycline -induced hypofibrinogenaemia :a systematic review
摘要: 目的 探讨替加环素致低纤维蛋白原血症的危险因素,为临床用药提供参考。方法计算机检索英文数据库(PubMed、CochraneLibrary、Embase、WebofScience)及中文数据库(中国期刊全文数据库、万方数据库、维普网及中国生物医学文献数据库)中有关替加环素致低纤维蛋白原血症危险因素的研究文献,检索时限为建库起至2022年2月5日,同时补充搜索未公开发表的临床试验数据。采用卡斯尔-渥太华量表(NOS)对纳入的文献进行质量评价,对符合纳入标准的文献进行数据提取,并采用RevMan5.3软件进行Meta分析或敏感性分析。结果最终入选8篇文献,中英文文献各4篇,均为病例对照研究,发表时限为2017-2021年,共涉及患者1374例,其中试验组、对照组分别有706、668例。Meta分析结果显示,替加环素致低纤维蛋白原血症的可能危险因素为:年龄[OR=1.04,95%CI(1.02,1.06),P=0.0005]、基线纤维蛋白原水平[OR=0.54,95%CI(0.42,0.69),P<0.00001)]、腹腔感染(敏感性分析)[OR=9.43,95%CI(4.24,20.95),P<0.00001]、单次给药剂量[OR=2.87,95%CI(2.04,4.02),P<0.00001]、用药时间[OR=1.10,95%CI(1.00,1.22),P=0.04]。结论高龄、低基线纤维蛋白原水平、腹腔感染、单次给药剂量偏高、用药时间偏长是替加环素致低纤维蛋白原血症的可能危险因素,患者若存在上述危险因素时,建议替加环素在用药过程中密切关注低纤维蛋白原血症的发生。
ABSTRACT: OBJECTIVE To investigate the risk factors for tigecycline -induced hypofibrinogenaemia by systematic review . METHODS The literature about risk factors for tigecycline -induced hypofibrinogenaemia were retrieved from English databases (PubMed,Cochrane Library ,Embase,Web of Science )and Chinese databases (CNKI,Wanfang Database ,VIP,CBM)during the inception to Feb . 5th,2022. At the same time ,the unpublished clinical trial data were additionally searched . After the quality evaluation of the included literature was carried out by adopting the Castle -Ottawa Scale (NOS),data were extracted from the literature that met the inclusion criteria ,and Meta -analysis was conducted by using RevMan 5.3 software. RESULTS Finally,8 literature were selected ,with a total of 1 374 cases,including 706 cases in the trial group and 668 cases in the control group . There were 4 Chinese and 4 English literature ,all of which were case control studies published between 2017-2021. Meta-analysis showed that the risk factors for tigecycline -induced hypofibrinogenaemia were age [OR=1.04,95%CI(1.02,1.06),P=0.000 5],baseline fibrinogen level [OR=0.54,95%CI(0.42,0.69),P<0.000 01],abdominal infection (sensitivity analysis )[OR=9.43,95%CI(4.24, 20.95),P<0.000 01],dose each time [OR=2.87,95%CI(2.04,4.02),P<0.000 01],medication time [OR=1.10,95%CI(1.00, 1.22),P=0.04]. CONCLUSIONS Advanced age ,low baseline fibrinogen levels ,abdominal cavity infection ,relative high dose each time and slightly long medication time are potential risk factors for tigecycline -induced hypofibrinogenaemia . If the above risk factors exist ,it is suggested to pay close attention to the occurrence of hypofibrinogenaemia in the course of tigecycline administration.
期刊: 2022年第33卷第19期
作者: 郝玉佩,孙晶,周春华,王玲娇,王婧,刘琰,于静
AUTHORS:
关键字: 替加环素;低纤维蛋白原血症;危险因素;Meta分析
KEYWORDS: tigecycline;hypofibrinogenaemia;risk factors ;meta-analysis
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