儿科药学杂志2025，Vol.31Issue(1)：44-47,4.DOI:10.13407/j.cnki.jpp.1672-108X.2025.01.009
多黏菌素B致儿童重症感染患者急性肾损伤的临床特征及危险因素分析
Clinical Characteristics and Risk Factors of Acute Kidney Injury Induced by Polymyxin B in Children with Severe Infections
韩露燕 1白雅敏 1刘静 1韩英 2张思梦 2刘文新1
作者信息
- 1. 衡水市妇幼保健院,河北衡水 053000
- 2. 首都医科大学附属北京儿童医院保定医院,河北保定 071000
- 折叠
摘要
Abstract
Objective:To analyze the clinical characteristics and risk factors of acute kidney injury(AKI)induced by polymyxin B in children with severe infections.Methods:Data of children with severe infection who received polymyxin B therapy in Hengshui Maternal and Child Health Hospital and Baoding Hospital,Beijing Children's Hospital,Capital Medical University from Jan.2021 to Feb.2024 were collected,all children were divided into the AKI group and non-AKI group.The incidence,occurrence time,severity,outcome and prognosis of AKI were analyzed.Risk factors for AKI were analyzed by univariate and multivariate logistic regression,odds ratios(OR)and the 95％confidence intervals(CI)were calculated.Results:Totally 157 children were enrolled,and 45 cases(28.66％)developed polymyxin B-associated AKI,with a mean onset time of(6.53±1.36)d.Kidney Disease:Improving Global Outcomes(KDIGO)stage of Ⅰ,Ⅱ and Ⅲ were respectively 26 cases(57.78％),11 cases(24.44％)and 8 cases(17.78％).The kidney function of 41 cases(91.11％)recovered after drug withdrawal,and 4 cases(8.89％)needed kidney replacement therapy.Univariate analysis showed that there were statistically significant differences between AKI group and non-AKI group in baseline albumin,baseline blood lactic acid,complicated with shock,combined with heat clearing and detoxifying traditional Chinese medicine injection,and loading doe and daily doe of polymyxin B(P＜0.05).Multivariate logistic regression analysis showed that baseline lactic acid＞2.0 mmol/L(OR=1.182,95％CI 1.146 to 2.865),complicated with shock(OR=3.652,95％CI 1.283 to 10.395)and daily dose of polymyxin B ≥75 mg(OR=3.015,95％CI 1.169 to 7.768)were independent risk factors for AKI induced by polymyxin B in children with severe infections(P＜0.05).Conclusion:The incidence of AKI induced by polymyxin B in children with severe infections is 28.66％.Hyperlactemia,shock and loading dose of polymyxin B are independent risk factors for AKI.关键词
多黏菌素B/儿童重症感染/急性肾损伤/危险因素Key words
polymyxin B/children with severe infections/acute kidney injury/risk factors分类
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韩露燕,白雅敏,刘静,韩英,张思梦,刘文新..多黏菌素B致儿童重症感染患者急性肾损伤的临床特征及危险因素分析[J].儿科药学杂志,2025,31(1):44-47,4.
