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两性霉素B脂质体引起低钾血症的危险因素分析
Analysis of risk factors for hypokalemia caused by amphotericin B liposome
- 中国药房 2023年34卷第17期 页码：2149-2153
- 作者机构：
1.海南医学院第一附属医院药学部，海口 570102
2.文昌市人民医院药学部，海南 文昌 571399
- 作者简介：
主管药师，硕士。研究方向：临床药学。电话：0898-66517965。E-mail：fxy08531@126.com
- 基金信息：海南省自然科学基金青年基金项目(819QN368)
DOI：10.6039/j.issn.1001-0408.2023.17.18
中图分类号： R969.3;R978.5纸质出版日期：2023-09-15，
收稿日期：2023-02-28，
修回日期：2023-08-17，
扫 描 看 全 文
符馨尹,张纯萍,郑秀芬等.两性霉素B脂质体引起低钾血症的危险因素分析 Δ[J].中国药房,2023,34(17):2149-2153.
FU Xinyin,ZHANG Chunping,ZHENG Xiufen,et al.Analysis of risk factors for hypokalemia caused by amphotericin B liposome[J].ZHONGGUO YAOFANG,2023,34(17):2149-2153.
符馨尹,张纯萍,郑秀芬等.两性霉素B脂质体引起低钾血症的危险因素分析 Δ[J].中国药房,2023,34(17):2149-2153. DOI： 10.6039/j.issn.1001-0408.2023.17.18.
FU Xinyin,ZHANG Chunping,ZHENG Xiufen,et al.Analysis of risk factors for hypokalemia caused by amphotericin B liposome[J].ZHONGGUO YAOFANG,2023,34(17):2149-2153. DOI： 10.6039/j.issn.1001-0408.2023.17.18.
摘要
目的
2
探讨两性霉素B脂质体引起低钾血症的危险因素，为临床合理用药提供参考。
方法
2
回顾性分析2012年1月至2021年12月在海南医学院第一附属医院住院期间使用两性霉素B脂质体的患者信息，收集其两性霉素B脂质体的使用详情和钾剂补充情况，按照是否发生低钾血症分成低钾血症组和正常组，采用单因素及多因素Logistic回归分析法分析两性霉素B脂质体引起低钾血症的危险因素。
结果
2
共纳入121例患者，其中低钾血症组60例、正常组61例。低钾血症组患者的两性霉素B脂质体维持剂量、累积剂量、最大日剂量（重度低钾血症患者）、治疗天数、出现低钾血症的时间、每日补钾剂量（中、重度低钾血症患者）、总补钾天数（中度低钾血症患者）均显著高于或长于正常组（
P
＜0.05）。单因素分析结果显示，两性霉素B脂质体累积剂量≥200 mg、治疗天数≥5 d对该药引起低钾血症有显著影响（
P
＜0.05）。多因素分析结果显示，患者存在基础低血钾、体重＜50 kg、两性霉素B脂质体累积剂量≥200 mg、治疗天数≥5 d是该药引起低钾血症的独立危险因素（
P
＜0.05）。
结论
2
两性霉素B脂质体引起低血钾症的发生率较高，其引起低钾血症的独立危险因素为累积剂量≥200 mg、治疗天数≥5 d、患者存在基础低血钾及体重＜50 kg。建议在应用该药治疗前将患者血清钾补充至正常水平，给药期间密切监测血清钾变化，以减少低钾血症的发生。
Abstract
OBJECTIVE
2
To investigate the risk factors for hypokalemia caused by amphotericin B liposome， and to provide reference for clinical use of drugs.
METHODS
2
A retrospective analysis was used to collect the information of patients who used amphotericin B liposome during the hospitalization in First Affiliated Hospital of Hainan Medical College from January 2012 to December 2021. The details of use information about amphotericin B liposome and the potassium supplementation were collected. The patients were divided into hypokalemia group and normal group according to the occurrence of hypokalemia. Univariate and multi-variate Logistic regression analyses were used to analyze the risk factors for hypokalemia induced by amphotericin B liposome.
RESULTS
2
Of the 121 patients included in this analysis， 60 patients were in hypokalemia group， 61 patients were in normal group. The following parameters of the hypokalemic group were significantly higher or longer than those of the normal group， such as the maintenance dose， cumulative dose and maximum daily dose （in patients with severe hypokalemia） of amphotericin B liposome， treatment days， the maintained days of hypokalemia， daily dose of potassium supplement （in patients with moderate or severe hypokalemia）， the duration of potassium supplement （in patients with moderate hypokalemia）. Results of single factor analysis showed that the cumulative dose of amphotericin B liposome ≥200 mg and the duration of treatment ≥5 days were independent risk factors of hypokalemia caused by this drug （
P
＜0.05）. Multi-variate analysis results showed that the presence of basic hypokalemia， body weight
＜50 kg， cumulative dose of amphotericin B liposome ≥200 mg and the duration of treatment ≥5 days were the independent risk factors for hypokalemia caused by amphotericin B liposome （
P
＜0.05）.
CONCLUSIONS
2
The incidence of hypokalemia caused by amphotericin B liposome is high， the independent risk factors for hypokalemia include cumulative dose ≥200 mg， treatment days ≥5 days， the presence of basic hypokalemia and body weight ＜50 kg. It is suggested that serum potassium should be elevated to normal level before amphotericin B liposome treatment， and the level of serum potassium should be monitored during medication to reduce the occurrence of hypokalemia.
关键词
两性霉素B脂质体低钾血症危险因素
Keywords
hypokalemiarisk factors
references
LIU M，CHEN M W，YANG Z W. Design of amphotericin B oral formulation for antifungal therapy[J]. Drug Deliv，2017，24（1）：1-9.
PAPPAS P G，KAUFFMAN C A，ANDES D R，et al. Exe- cutive summary：clinical practice guideline for the mana- gement of candidiasis：2016 update by the Infectious Diseases Society of America[J]. Clin Infect Dis，2016，62（4）：409-417.
SEIBEL N L，SHAD A T，BEKERSKY I，et al. Safety，tole- rability，and pharmacokinetics of liposomal amphotericin B in immunocompromised pediatric patients[J]. Antimicrob Agents Chemother，2017，61（2）：e01477-e01416.
STEIMBACH L M，TONIN F S，VIRTUOSO S，et al. Efficacy and safety of amphotericin B lipid-based formulations：a systematic review and meta-analysis[J]. Mycoses，2017，60（3）：146-154.
STONE N R H，BICANIC T，SALIM R，et al. Liposomal amphotericin B （AmBisome（®））：a review of the pharmacokinetics，pharmacodynamics，clinical experience and future directions[J]. Drugs，2016，76（4）：485-500.
PATEL G P，CRANK C W，LEIKIN J B. An evaluation of hepatotoxicity and nephrotoxicity of liposomal amphotericin B （L-AMB）[J]. J Med Toxicol，2011，7（1）：12-15.
OKADA N，AZUMA M，IMANISHI M，et al. Potential usefulness of early potassium supplementation for preven- ting severe hypokalemia induced by liposomal amphotericin B in hematologic patients：a retrospective study[J]. Clin Ther，2018，40（2）：252-260.
朱彦，李志玲，孟琳懿，等. 注射用两性霉素B脂质体致早产儿左心收缩功能不全1例[J]. 中国医院药学杂志，2017，37（4）：402-403.
国家药典委员会. 中华人民共和国药典临床用药须知：中药卷[M]. 2005年版.北京：人民卫生出版社，2005：589.
LEVEY A S，DE JONG P E，CORESH J，et al. The definition，classification，and prognosis of chronic kidney di- sease：a KDIGO Controversies Conference report[J]. Kidney Int，2011，80（1）：17-28.
TASSET C，PREAT V，BERNARD A，et al. Comparison of nephrotoxicities of different polyoxyethyleneglycol formulations of amphotericin B in rats[J]. Antimicrob Agents Chemother，1992，36（7）：1525-1531.
HOPE W W，GOODWIN J，FELTON T W，et al. Population pharmacokinetics of conventional and intermittent dosing of liposomal amphotericin B in adults：a first critical step for rational design of innovative regimens[J]. Antimicrob Agents Chemother，2012，56（10）：5303-5308.
LE T，LY V T，THU N T M，et al. Population pharmacodynamics of amphotericin B deoxycholate for disseminated infection caused by Talaromyces marneffei[J]. Antimicrob Agents Chemother，2019，63（2）：e01739-e01718.
KARIMZADEH I，KHALILI H，FARSAEI S，et al. Role of diuretics and lipid formulations in the prevention of amphotericin B-induced nephrotoxicity[J]. Eur J Clin Pharmacol，2013，69（7）：1351-1368.
WADE R L，CHAUDHARI P，NATOLI J L，et al. Comparison of adverse events and hospital length of stay associated with various amphotericin B formulations：sequential conventional amphotericin b/lipid versus lipid-only therapy for the treatment of invasive fungal infections in hospitalized patients[J]. P T，2013，38（5）：278-287.
OTA Y，OBATA Y，TAKAZONO T，et al. Association between potassium supplementation and the occurrence of acute kidney injury in patients with hypokalemia admini- stered liposomal amphotericin B：a nationwide observational study[J]. BMC Nephrol，2021，22（1）：240.
YAMAZAKI H，KONDO T，AOKI K，et al. Occurrence and improvement of renal dysfunction and serum potassium abnormality during administration of liposomal amphotericin B in patients with hematological disorders：a retrospective analysis[J]. Diagn Microbiol Infect Dis，2018，90（2）：123-131.
HAY R J. Liposomal amphotericin B，AmBisome[J]. J Infect，1994，28：35-43.
USAMI E，KIMURA M，KANEMATSU T，et al. Evaluation of hypokalemia and potassium supplementation du- ring administration of liposomal-amphotericin B[J]. Exp Ther Med，2014，7（4）：941-946.
ABDEL-HAFEZ Y，SIAJ H，JANAJRI M，et al. Tolerabi- lity and epidemiology of nephrotoxicity associated with conventional amphotericin B therapy：a retrospective study in tertiary care centers in Palestine[J]. BMC Nephrol，2022，23（1）：132.
王学莉，伏添，王成立，等. 两性霉素B治疗侵袭性肺部真菌感染的临床分析[J]. 中国真菌学杂志，2014，9（3）：163-166.
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