老年人静脉输注头孢哌酮舒巴坦钠发生肝功能异常的危险因素分析

摘要/Abstract

摘要： 目的探究老年人静脉输注头孢哌酮舒巴坦钠发生肝功能异常的危险因素。方法回顾性随机选取合肥市第二人民医院2021年1月至2023年7月收治的静脉输注头孢哌酮舒巴坦钠抗感染治疗的老年患者274例并纳入研究。观察患者用药期间肝功能异常发生情况,并分析肝功能异常的影响因素。结果老年患者静脉输注头孢哌酮舒巴坦钠后肝功能异常发生率为8.76%(24/274)。单因素分析结果显示,两组性别、体质指数(BMI)、吸烟、合并高血压、冠心病、脑梗死、基础疾病、白蛋白(Alb)水平、每日用药剂量、合并用药、尿素氮(BUN)水平比较差异无统计学意义(P>0.05)。肝功能异常组年龄[(76.7±4.0)岁vs.(72.2±3.8)岁]、饮酒[62.50%(15/24)vs. 38.00%(95/250)]、合并糖尿病占比[75.00%(18/24)vs. 50.40%(126/250)]、总胆红素(TBil)[(13.46±2.69)μmol/L vs.(10.47±2.08)μmol/L]、凝血酶原时间(PT)[(15.52±1.03)s vs.(14.23±0.47)s]、用药时长≥5 d占比[58.33%(14/24)vs. 28.40%(71/250)]均高于肝功能正常组(P<0.05)。多因素logistic结果显示,年龄(OR=3.601,95%CI:1.491~8.699)、PT(OR=3.107,95%CI:1.543~6.254)、用药时长(OR=4.045,95%CI:2.085~7.845)、TBil(OR=6.039,95%CI:1.702~21.421)是肝功能异常的危险因素(P<0.05)。结论年龄、TBil、PT、用药时长是老年人静脉输注头孢哌酮舒巴坦钠后发生肝功能异常的危险因素。在用药期间,临床对于合并上述危险因素的老年患者应加强监测患者肝功能,一旦出现异常立即采取措施进行干预。

关键词: 静脉输注头孢哌酮舒巴坦钠, 老年患者, 肝功能异常, 影响因素

Abstract: Objective To investigate the risk factors of liver dysfunction in elderly patients with intravenous infusion of cefoperazone sulbactam sodium. Methods A total of 274 elderly patients who received intravenous infusion of cefoperazone sulbactam sodium for anti-infective treatment in the Hefei Second People′s Hospital from January 2021 to July 2023 were retrospectively included in this study. The occurrence of abnormal liver function during medication was observed, and the influencing factors of abnormal liver function were analyzed. Results The incidence of abnormal liver function after intravenous infusion of cefoperazone sulbactam sodium in elderly patients was 8.76% (24/274). The results of univariate analysis showed that there were no statistically significant differences in gender, body mass index (BMI), smoking, hypertension, coronary heart disease, cerebral infarction, underlying diseases, albumin (Alb) level, daily medication dose, combined medication, and blood urea nitrogen (BUN) level between the two groups (P>0.05). The age [(76.7±4.0) years vs. (72.2±3.8) years], drinking history [62.50% (15/24) vs. 38.00% (95/250)], proportion of combined diabetes [75.00% (18/24) vs. 50.40% (126/250)], total bilirubin (TBil) [(13.46±2.69) μmol/L vs. (10.47±2.08) μmol/L], prothrombin time (PT) [(15.52±1.03) s vs. (14.23±0.47) s], and the proportion of medication time ≥5 days [58.33%(14/24)vs. 28.40%(71/250)] in the abnormal liver function group were higher than those in the normal liver function group (P<0.05). Multivariate Logistic regression analysis showed that age (OR=3.601, 95%CI: 1.491~8.699), PT (OR=3.107, 95%CI: 1.543~6.254), medication time (OR=4.045, 95%CI: 2.085~7.845) and TBil (OR=6.039, 95%CI: 1.702~21.421) were risk factors for abnormal liver function (P<0.05). Conclusion Age, TBil, PT levels and medication time are risk factors for abnormal liver function after intravenous infusion of cefoperazone sulbactam sodium in the elderly. Therefore, we should strengthen the monitoring of liver function in elderly patients with the above risk factors during medication, and take immediate intervention measures once abnormal results occur.

Key words: Intravenous infusion of cefoperazone sulbactam sodium, Elderly patients, Abnormal liver function, Influencing factors

刘娟娟, 洪源源, 王凤玲, 余学江, 孟祥云. 老年人静脉输注头孢哌酮舒巴坦钠发生肝功能异常的危险因素分析[J]. 肝脏, 2025, 30(11): 1557-1560.

LIU Juan-juan, HONG Yuan-yuan, WANG Feng-ling, YU Xue-jiang, MENG Xiang-yun. Analysis of risk factors for hepatic dysfunction in elderly patients after intravenous infusion of cefoperazone and sulbactam sodium[J]. Chinese Hepatolgy, 2025, 30(11): 1557-1560.

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