中国药业2025，Vol.34Issue(9)：113-116,4.DOI:10.3969/j.issn.1006-4931.2025.09.025
万古霉素致白细胞减少症患者白细胞计数恢复正常的影响因素分析
Influencing Factors of the Recovery of White Blood Cell Count to Normalization in Patients with Leukopenia Induced by Vancomyci
摘要
Abstract
Objective To provide a reference for the safe and rational use of vancomycin in the clinic.Methods The National Adverse Drug Reaction Monitoring System was searched to collect adverse drug reaction(ADR)reports of leukopenia induced by vancomycin from January 2006 to December 2022.The patients'gender,age,type of infection,white blood cell count(WBC),treatment drugs,and outcomes were collected.Based on whether vancomycin was withdrawal after the onset of leukopenia,patients were divided into the withdrawal group(36 cases)and the non-withdrawal group(24 cases),and the clinical characteristics and recovery time for WBC to normalization between the two groups were compared.According to whether the WBC has returned to normal(>4.0×109/L),patients were divided into the recovery group(20 cases)and the unrecovered group(40 cases).Binary Logistic multivariate regression analysis was used to analyze the influencing factors of WBC recovery in patients with leukopenia induced by vancomycin.Results Among the 60 patients,there were 40 males and 20 females;the average age was 51.13 years old;18 patients aged>65;the average course of treatment for vancomycin was 14.7 d,with an average daily dose of 1.92 g and an average cumulative dose of 27.28 g.Compared with those in the withdrawal group,the patients'age was significantly younger in the non-withdrawal group(P<0.05);the cases of intracranial infections were significantly fewer in the non-withdrawal group(P<0.05),while the cases of bone tissue infections,monitoring of vancomycin blood concentration,and use of human granulocyte colony-stimulating factor were significantly more in the non-withdrawal group(P<0.05);the recovery time for WBC to normalization was significantly longer in the non-withdrawal group(P<0.05).The results of binary Logistic multivariate regression analysis showed that the patients'baseline WBC was positively correlated with the recovery of WBC to normalization in patients with leukopenia induced by vancomycin[OR=0.004,95%CI(0.000,0.490),P=0.024].Conclusion Patients receiving vancomycin treatment should discontinue the drug as soon as leukopenia occurs.Severe patients may consider using drugs such as human granulocyte colony-stimulating factor for treatment.Patients with long-term drug use should monitor the blood concentration of vancomycin to avoid adverse reactions.关键词
万古霉素/白细胞减少症/白细胞计数/药品不良反应Key words
vancomycin/leukopenia/white blood cell count/adverse drug reactions分类
医药卫生引用本文复制引用
赵芳芳,褚燕琦,刘琛,白向荣..万古霉素致白细胞减少症患者白细胞计数恢复正常的影响因素分析[J].中国药业,2025,34(9):113-116,4.基金项目
北京市属医院科研培育计划项目[PX20200805]. （）
