低白蛋白血症对肺部感染患者替加环素血药浓度、临床疗效及安全性的影响OA

AIM To investigate the impact of hypoalbuminemia on blood concentration,clinical efficacy,and adverse reactions of tigecycline(TGC)in patients with pulmonary infections.METHODS A total of 60 patients with pulmonary infections were enrolled and divided into a hypoalbuminemia group(n=29)and a non-hypoalbuminemia group(n=31)based on their serum albumin levels at enrollment.After tigecycline treatment reached a steady state,the total trough blood concentration(Ct,min)and free trough concentration(Cf min)were measured by LC-MS/MS.The clinical efficacy and adverse drug reactions of patients in 2 groups were evaluated at the end of the course of treatment.The Ct,min,Cf,min clinical efficacy rate and the incidence of adverse reactions were compared between 2 groups.RESULTS The Ct,min and Cf min in the hypoalbuminemia group were 201.0(152.0,348.0)ng·mL-1,and 171.0(123.0,303.0)ng·mL-1,respectively,while in the non-hypoalbuminemia group,they were 241.0(155.0,297.0)ng·mL-1 and 173.0(119.0,270.0)ng·mL-1,respectively,with no statistically significant difference between 2 groups(P＞0.05).However,the clinical response rate in the hypoalbuminemia group(55.2％)was significantly lower than that in the non-hypoalbuminemia group(83.9％,P＜0.05).In terms of adverse reactions,the incidence of elevated alkaline phosphatase(34.5％vs 12.9％)and reduced fibrinogen(48.3％vs 16.1％)was significantly higher in the hypoalbuminemia group than in the non-hypoalbuminemia group(P＜0.05),with no significant differences in the incidence of other adverse reactions between 2 groups.CONCLUSION Although the blood concentration of tigecycline is not affected by hypoalbuminemia,it reduces clinical efficacy and increases the risk of adverse reactions.It is recommended to strengthen the monitoring of blood concentration and serum albumin levels in hypoalbuminemia patients using tigecycline to optimize treatment outcomes and reduce adverse reactions.