■哌拉西林/他唑巴坦(PIPC/TAZ),它是β-内酰胺/β-内酰胺酶抑制剂的组合,常引起肝酶异常。白蛋白-胆红素(ALBI)评分是使用血清白蛋白和总胆红素水平评估肝功能储备的简单指标。尽管低肝脏储备的患者可能存在药物性肝酶异常的高风险,PIPC/TAZ诱导的异常肝酶水平与ALBI评分之间的关系尚不清楚.
■本研究旨在阐明PIPC/TAZ诱导的异常肝酶水平与ALBI评分之间的关系。
■这项单中心回顾性病例对照研究包括335名患者。主要结果是PIPC/TAZ诱导的异常肝酶水平。我们用男性进行COX回归分析,年龄(≥75岁),丙氨酸氨基转移酶水平(≥20IU/L),和ALBI评分(≥-2.00)作为解释因素。探讨ALBI评分对肝酶异常发展的影响,使用药物引起的肝酶水平异常的危险因素,在≤-2.00和≥-2.00ALBI评分组之间进行1:1倾向评分匹配。
■肝酶水平异常的发生率为14.0%(47/335)。COX回归分析显示,ALBI评分≥-2.00是PIPC/TAZ诱导的肝酶水平异常的独立危险因素(校正风险比:3.08,95%系数区间:1.207-7.835,P=0.019)。1:1倾向评分匹配后,Kaplan-Meier曲线显示,ALBI评分≥-2.00组(n=76)的PIPC/TAZ诱导的肝酶水平异常累积风险显著高于<-2.00组(n=76)(P=0.033).
■ALBI评分≥-2.00可以预测PIPC/TAZ诱导的异常肝酶水平的发展。因此,在肝功能储备低的患者中,应频繁监测肝酶,以最大程度降低严重PIPC/TAZ诱导的肝酶水平异常的风险.
UNASSIGNED: Piperacillin/tazobactam (PIPC/TAZ), which is a combination of a beta-lactam/beta-lactamase inhibitor, often causes liver enzyme abnormalities. The albumin-bilirubin (ALBI) score is a simple index that uses the serum albumin and total bilirubin levels for estimating hepatic functional reserve. Although patients with low hepatic reserve may be at high risk for drug-induced liver enzyme abnormalities, the relationship between PIPC/TAZ-induced abnormal liver enzymes levels and the ALBI score remains unknown.
UNASSIGNED: This study aimed to elucidate the relationship between PIPC/TAZ-induced abnormal liver enzyme levels and the ALBI score.
UNASSIGNED: This single-center retrospective
case-control study included 335 patients. The primary outcome was PIPC/TAZ-induced abnormal liver enzyme levels. We performed COX regression analysis with male gender, age (≥75 years), alanine aminotransferase level (≥20 IU/L), and ALBI score (≥-2.00) as explanatory factors. To investigate the influence of the ALBI score on the development of abnormal liver enzyme levels, 1:1 propensity score matching between the ≤-2.00 and ≥-2.00 ALBI score groups was performed using the risk factors for drug-induced abnormal liver enzyme levels.
UNASSIGNED: The incidence of abnormal liver enzyme levels was 14.0% (47/335). COX regression analysis revealed that an ALBI score ≥-2.00 was an independent risk factor for PIPC/TAZ-induced abnormal liver enzyme levels (adjusted hazard ratio: 3.08, 95% coefficient interval: 1.207-7.835, P = 0.019). After 1:1 propensity score matching, the Kaplan-Meier curve revealed that the cumulative risk for PIPC/TAZ-induced abnormal liver enzyme levels was significantly higher in the ALBI score ≥-2.00 group (n = 76) than in the <-2.00 group (n = 76) (P = 0.033).
UNASSIGNED: An ALBI score ≥-2.00 may predict the development of PIPC/TAZ-induced abnormal liver enzyme levels. Therefore, frequent monitoring of liver enzymes should be conducted to minimize the risk of severe PIPC/TAZ-induced abnormal liver enzyme levels in patients with low hepatic functional reserve.