Influencing factors for meropenem-related liver injury and their predictive value
- VernacularTitle:美罗培南相关肝损伤的影响因素及其预测价值
- Author:
Yan HE
1
;
Hongqin KE
2
;
Hongliang LI
1
;
Jianyong ZHU
3
;
Lijun ZHAO
1
;
Huibin YU
1
Author Information
- Publication Type:Journal Article
- Keywords: Meropenem; Liver Injury; Influencing Factors
- From: Journal of Clinical Hepatology 2025;41(3):506-512
- CountryChina
- Language:Chinese
- Abstract: ObjectiveTo analyze the factors influencing meropenem-related liver injury （MRLI） and to explore their clinical predictive value. MethodsA 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. ResultsThe 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. ConclusionMale 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.
