临床肝胆病杂志2025，Vol.41Issue(3)：506-512,7.DOI:10.12449/JCH250317
美罗培南相关肝损伤的影响因素及其预测价值
Influencing factors for meropenem-related liver injury and their predictive value
摘要
Abstract
Objective To analyze the factors influencing meropenem-related liver injury(MRLI)and to explore their clinical predictive value.Methods A retrospective case-control study was conducted,and the Chinese Hospital Pharmacovigilance System(CHPS)was used to establish a retrieval scheme.A total of 1 625 hospitalized cases using meropenem from January 2018 to December 2022 were collected.Patients were divided into case group(n=62)and control group(n=1 563)based on the presence or absence of liver injury.Clinical data and laboratory indicators from both groups were collected and analyzed.The t-test was used for comparison of normally distributed continuous data between the two groups,while the Mann-Whitney U test was used for comparison of continuous data not conforming to a normal distribution.The chi-square test was used for comparison of categorical data between the two groups.A multivariate Logistic regression analysis was performed to identify the influencing factors for MRLI.A Logistic regression equation was established,and the predictive value of these factors was assessed using the receiver operating characteristic(ROC)curve.Results The results of univariate analysis indicated that the rates of male patients,hypoproteinemia,shock,intensive care unit(ICU)admissions,sepsis,and liver,gallbladder,and cardiovascular diseases,the levels of alanine aminotransferase(ALT),alkaline phosphatase(ALP),gamma-glutamyl transpeptidase(GGT),aspartate aminotransferase(AST),creatinine(CREA),and procalcitonin(PCT),and the number of hospitalization days were significantly higher in the case group than in the control group(P<0.05),and that the platelet levels in the case group were significantly lower than those in the control group(P<0.05).The multivariate Logistic regression analysis showed that male sex(odds ratio[OR]=2.080,95%confidence interval[CI]:1.050-4.123,P=0.036),admission to the ICU(OR=8.207,95%CI:4.094-16.453,P<0.001),comorbidity with gallbladder disease(OR=8.240,95%CI:3.605-18.832,P<0.001),ALP(OR=1.012,95%CI:1.004-1.019,P=0.004),GGT(OR=1.010,95%CI:1.005-1.015,P<0.001),and PLT(OR=0.997,95%CI:0.994-0.999,P=0.020)were the influential factors for MRLI.The areas under the ROC curve of ALP,GGT,and PLT were 0.589,0.637,and 0.595,respectively,and the AUC of them combined was 0.837.Conclusion Male sex,ICU admission,comorbidity with gallbladder disease,increased ALP,increased GGT,and decreased PLT were influencing factors for MRLI,and a combination of factors has a better predictive value for the occurrence of MRLI.关键词
美罗培南/肝损伤/影响因素Key words
Meropenem/Liver Injury/Influencing Factors引用本文复制引用
贺艳,柯洪琴,李洪亮,朱建勇,赵利军,于慧斌..美罗培南相关肝损伤的影响因素及其预测价值[J].临床肝胆病杂志,2025,41(3):506-512,7.基金项目
湖北省自然科学基金(2023AFB925) （2023AFB925）
"十四五"湖北省高等学校优势特色学科群(生物与医药)项目(2023BMXKQT5) （生物与医药）
武当特色中药研究湖北省重点实验室(湖北医药学院)开放课题(WDCM2023013) Natural Science Foundation of Hubei Provincial(2023AFB925) （湖北医药学院）
the Advantages Discipline Group(Biology and Medicine)Project in Higher Education of Hubei Province(2021-2025)(2023BMXKQT5) （Biology and Medicine）
the Open Project of Hubei Key Laboratory of Wudang Local Chinese Medicine Research(Hubei University of Medicine)(WDCM2023013) （Hubei University of Medicine）
