基于回顾性队列的替加环素相关肝损伤危险因素分析OA

Objective To investigate the incidence and independent risk factors of Tigecycline(TGC)-associated drug-induced liver injury(DILI)for providing evidence for optimizing dosing strategies and risk early-warning systems.Methods Clinical data were col-lected from adult patients who received TGC for more than three days in Shanxi Provincial People's Hospital.Based on the occurrence of liver injury,the patients were divided into liver injury group and non-liver injury group.Demographic characteristics,medication details,laboratory parameters,and other clinical variables were compared between the two groups.Univariate and multivariate Logistic regression analyses were employed to identify independent risk factors for TGC-associated liver injury,and the cutoffs for the indepen-dent risk factors were determined using receiver operating characteristic(ROC)curve analysis.Results A total of 375 adult patients were included in this study.The incidence of TGC-associated DILI was 14.4%(54/375).No significant differences were observed in demographic data,infection sites,comorbidities,baseline liver biochemistry,or other clinical characteristics between the two groups(all P>0.05).Univariate and multivariate Logistic regression analyses identified age≥60 years(OR=2.163,95%CI:1.179-3.969,P=0.013)and duration of TGC therapy(OR=1.102,95%CI:1.030-1.178,P=0.005)as independent risk factors for TGC-associated DILI.The baseline PLT count was identified as a protective factor(OR=0.997,95%CI:0.994-0.999,P=0.008).ROC curve analysis indicated a significant increase in DILI risk when the duration of TGC therapy exceeded 13 d(AUC=0.623).Conclusion Patients aged≥60 years treated with TGC for more than 13 days are at an increased risk of developing TGC-associated DILI.Therefore,close monitoring of liver function is recommended in these patients to ensure the safe and effective use of TGC.