在0岁至1岁的儿科患者中,使用日本医学数据库对万科米辛诱导的毒性进行风险因子分析
Takayuki Miyai1, Yoh Takekuma2, Hitoshi Kashiwagi3
1Graduate School of Life Science, Hokkaido University.
Biological & pharmaceutical bulletin
|May 31, 2023
概括
婴儿中的万科米辛诱导性毒性 (VIN) 与血管压缩剂的使用有关. 这项研究确定了幼儿VIN的风险因素,表明血管压缩剂增加风险.
科学领域:
- 儿科脏病学 儿科脏病学
- 临床药理学 临床药理学
- 医疗信息学 医疗信息学
背景情况:
- 范科米辛诱导的毒性 (VIN) 是儿科患者的一个重大问题.
- 目前对VIN的研究主要集中在年龄较大的儿童 (0-18岁),在了解婴儿的风险方面存在差距.
- 婴儿是脆弱群体,需要对药物诱导的损伤进行特定的风险因素评估.
研究的目的:
- 确定和评估与0至1岁儿童患者的万科米辛诱导毒性 (VIN) 相关的风险因素.
- 分析一个大型的日本电子医疗记录数据库,以揭示这个年龄段的特定风险因素.
- 提供可以帮助开发婴儿VIN预测模型的数据.
主要方法:
- 利用RWD数据库,包含来自160个机构大约2000万个人的电子医疗记录和索赔数据.
- 包括在2000年6月至2020年12月期间服用万科米辛 (VCM) 的住院患者.
- 使用基于血清肌素 (Scr) 变化的两个标准定义VIN,并采用多变量逻辑回归分析来确定风险因素.
主要成果:
- 对446名患者的分析揭示了33例 (标准1) 和58例 (标准2) 的VIN.
- 标准1确定了VCM度 (≥20 mg/L),安福特 B,皮佩拉-塔扎巴克坦和血管压缩剂药物作为独立的风险因素.
- 标准2表明,与血管抑制药物的同时使用是显著的危险因素 (p<0.05).
结论:
- 同时使用血管抑制药物是0至1岁的患者中菌素诱导性毒性 (VIN) 的重要危险因素.
- 高米素度,同时服用安福特里辛B和皮佩拉西林-塔扎巴克坦也会导致该人群的VIN风险.
- 这些发现对于制定有针对性的策略来减轻婴儿和幼儿VIN风险至关重要.
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