头孢哌酮舒巴坦致成人凝血功能异常危险因素的系统评价
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篇名: 头孢哌酮舒巴坦致成人凝血功能异常危险因素的系统评价
TITLE: Study on the risk factors of cefoperazone/sulbactam-induced coagulation dysfunction in adult patients:a systematic review
摘要: 目的 评价头孢哌酮舒巴坦致成人凝血功能异常的危险因素。方法检索中国知网、维普网、中国生物医学数据库、万方数据、PubMed、Embase、Cochrane图书馆,收集头孢哌酮舒巴坦致成人凝血功能异常的随机对照试验(RCT)、病例对照研究或队列研究,检索时限为数据库建库至2023年4月30日。筛选文献、提取数据及评价其质量后,采用RevMan5.3软件进行Meta分析。结果共纳入13篇文献,其中病例对照研究11篇,队列研究2篇,共计18387例患者。Meta分析结果显示,凝血功能异常患者中高龄[OR=2.04,95%CI(1.14,3.64),P=0.02]、肝功能不全[OR=5.95,95%CI(4.21,8.40),P<0.00001]、肾功能不全[OR=3.51,95%CI(3.04,4.05),P<0.001]、低蛋白血症[OR=1.90,95%CI(1.37,2.62),P<0.001]、进食欠佳[OR=7.25,95%CI(5.13,10.24),P<0.00001]、头孢哌酮舒巴坦日剂量≥9g[OR=3.95,95%CI(2.45,6.37),P<0.001]、头孢哌酮舒巴坦用药疗程≥10d[OR=2.43,95%CI(1.81,3.28),P<0.001]、联用抗凝药物[OR=2.84,95%CI(2.03,3.97),P<0.001]、合并恶性肿瘤[OR=1.60,95%CI(1.20,2.15),P<0.001]的构成比均显著高于凝血功能正常患者。结论高龄、肝肾功能不全、合并恶性肿瘤、低蛋白血症、联用抗凝药物、进食欠佳、日剂量≥9g和用药疗程≥10d是头孢哌酮舒巴坦致凝血功能异常的危险因素。
ABSTRACT: OBJECTIVE To systematically evaluate the risk factors for cefoperazone/sulbactam-induced coagulation dysfunction in adult patients. METHODS Retrieved from CNKI, VIP, CBM, Wanfang data, PubMed, Embase and Cochrane Library, randomized controlled trial (RCT), case-control study or cohort study about cefoperazone/sulbactam-induced coagulation dysfunction in adult patients were collected from the inception to Apr. 30th, 2023. After literature screening, data extraction and quality evaluation, meta-analysis was carried out by using RevMan 5.3 software. RESULTS A total of 13 studies were included, among which 11 studies were case-control studies, and 2 studies were cohort studies, involving 18 387 patients in total. Meta- analysis showed that the proportion of advanced age [OR=2.04, 95%CI (1.14, 3.64), P=0.02], liver insufficiency [OR=5.95, 95%CI (4.21, 8.40), P<0.000 01], renal insufficiency [OR=3.51, 95%CI (3.04, 4.05), P<0.001], hypoproteinemia [OR= 1.90, 95%CI(1.37, 2.62), P<0.001], poor diet [OR=7.25, 95%CI (5.13, 10.24), P<0.000 01], daily dose of cefoperazone/ sulbactam ≥9 g [OR=3.95, 95%CI (2.45,6.37), P<0.001], medication duration of cefoperazone/sulbactam ≥10 d [OR=2.43, 95%CI (1.81, 3.28), P<0.001], combined use of anticoagulant drugs [OR=2.84, 95%CI (2.03, 3.97), P<0.001], combined with malignant tumor [OR=1.60, 95%CI (1.20, 2.15),P<0.001] in patients with abnormal coagulation function were significantly higher than those with normal coagulation function. CONCLUSIONS Advanced age, liver insufficiency, renal insufficiency, complicated with malignant tumors and hypoalbuminemia, combined use of anticoagulant drugs, poor diet, daily dose ≥9 g, and medication duration≥10 days are risk factors for coagulation dysfunction caused by cefoperazone/sulbactam.
期刊: 2024年第35卷第04期
作者: 脱鸣富;唐彩娥;杨鲲;沈亚兵;雷世鑫;杨亮
AUTHORS: TUO Mingfu,TANG Cai’e,YANG Kun,SHEN Yabing,LEI Shixin,YANG Liang
关键字: 头孢哌酮舒巴坦;凝血功能异常;危险因素;系统评价
KEYWORDS: cefoperazone/sulbactam; coagulation dysfunction;
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