Risk factors of linezolid-related thrombocytopenia in patients with liver cirrhosis
10.16718/j.1009-7708.2018.02.006
- VernacularTitle:肝硬化患者利奈唑胺相关血小板减少症的危险因素分析
- Author:
Miaotian CAI
1
;
Tongzeng LI
;
Zhonghui DUAN
;
Danlei MOU
;
Lianchun LIANG
Author Information
1. 首都医科大学附属北京佑安医院感染综合科
- Keywords:
liver cirrhosis;
linezolid;
thrombocytopenia;
risk factor
- From:
Chinese Journal of Infection and Chemotherapy
2018;18(2):156-162
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the incidence and potential risk factors of linezolid (LZD) related thrombocytopenia (TP) in patients with liver cirrhosis (LC). Methods Clinical data of LC patients treated with LZD for at least 1 dose (600 mg per 12 h) between January 2013 and May 2017 were retrospectively collected and analyzed to investigate the incidence and risk factors of LZD-related TP defined as platelet count during LZD therapy ≤ 50×109/L or a decline by ≥25％ of the baseline level. Results A total of 52 patients with LC were included in this study. The cumulative incidence of LZD-related TP was 51.9％ (27/52), of which 85.2％ (23/27) was severe TP (decline of platelet count by ≥50％ of the baseline level). Multivariate logistic regression analysis showed that the baseline platelet count ≤110 ×109/L (OR=6.989, 95％ CI: 1.192-40.971, P=0.031), LZD course ≥ 7 d (OR=9.478, 95％ CI: 1.349-66.587, P=0.024) and LZD dose ≥ 17 mg·kg-1·d-1 (OR=0.062, 95％ CI: 0.010-0.383, P=0.003) were independent risk factors of LZD-related TP in LC patients. Kaplan-Meier analysis revealed that the overall median time from the initiation of LZD therapy to in-hospital death was 18 days in TP patients and 13 days in non-TP patients without significant difference (P＞0.05). Cox proportional-hazards regression revealed no significant correlation between the in-hospital mortality and LZD-related TP in LC patients (P＞0.05). Conclusions Patients with LC are at high risk of LZD-related TP, but not associated with organ hemorrhage during LZD therapy and in-hospital mortality. Platelet count should be monitored more closely during LZD therapy for LC patients with lower baseline platelet count and longer LZD course.
