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目的:探讨静脉用克林霉素发生急性肾衰竭的危险因素,提出相应的防治措施。方法:采用回顾性分析方法,对某院2011年1月-2012年12月静脉注射克林霉素药物发生急性肾衰竭的患者及同期静脉注射克林霉素药物未发生急性肾衰竭的患者进行病例对照研究,用单因素分析及多因素Logistic回归分析的方法研究患者性别、年龄、病程、剂量、滴注速度、药物浓度、使用频率、联合用药、过敏史、疗程是否是引起克林霉素致急性肾衰竭的相关因素。结果:单因素分析结果显示:性别、年龄、过敏史、病程与静脉用克林霉素致急性肾衰竭无相关性(P>0.05),多因素Logistic回归分析结果剂量、滴注速度、药物浓度、使用频率、联合用药、疗程这6项是静脉用克林霉素致急性肾衰竭的高危因素。药物浓度和用药次数为克林霉素静滴致输液部位疼痛的相关因素(P<0.05)。结论:静脉用克林霉素发生急性肾衰竭是多种多种因素共同作用的结果,控制药物的剂量、滴注速度、药物浓度、使用频率、联合用药、疗程是减少不良反应的关键,从而提高克林霉素的临床使用安全性。
Objective: To investigate the risk factors of acute renal failure caused by intravenous clindamycin and to put forward corresponding prevention and treatment measures. Methods: A retrospective analysis of a hospital from January 2011 to December 2012 intravenous clindamycin in patients with acute renal failure and the same period of intravenous clindamycin did not occur in patients with acute renal failure Case-control study, using univariate analysis and multivariate Logistic regression analysis of patients with gender, age, duration, dosage, infusion rate, drug concentration, frequency of use, combination therapy, history of allergy, treatment is caused by clindamycin Causes of acute renal failure related factors. Results: The results of univariate analysis showed that gender, age, history of allergy and course of disease had no correlation with intravenous clindamycin-induced acute renal failure (P> 0.05), and multivariate Logistic regression analysis showed that the dose, instillation speed and drug concentration , The frequency of use, combination therapy, treatment of these six items is the risk of clindamycin-induced acute renal failure risk factors. The drug concentration and medication frequency were the factors related to the pain caused by infusion of clindamycin intravenously (P <0.05). Conclusion: The acute renal failure caused by intravenous clindamycin is the result of many kinds of factors. The key to reduce the adverse reactions is to control the dosage, infusion speed, drug concentration, frequency of use, combination therapy and treatment course Improve the clinical use of clindamycin safety.