天津医药

天津医药 ›› 2025, Vol. 53 ›› Issue (9): 937-941.doi: 10.11958/20252000

• 临床研究 • 上一篇    下一篇

哌拉西林他唑巴坦致低钾血症的危险因素分析

周利军1,2(), 曾文静1,3, 胡琴1,3,△()   

  1. 1 中南大学湘雅医院药学部（邮编410008）
    2 中国人民解放军总医院海南医院药剂科
    3 国家老年疾病临床医学研究中心（湘雅医院）
  • 收稿日期:2025-05-16 修回日期:2025-07-21 出版日期:2025-09-15 发布日期:2025-09-16
  • 通讯作者: △E-mail：huqin2016@csu.edu.cn
  • 作者简介:周利军（1986），女，主管药师，主要从事临床药学方面研究。E-mail：zhoulijun2233@126.com
  • 基金资助:
    湖南省自然科学基金资助项目(2022JJ80045)

Analysis of risk factors for hypokalemia caused by piperacillin/tazobactam

ZHOU Lijun1,2(), ZENG Wenjing1,3, HU Qin1,3,△()   

  1. 1 Department of Pharmacy, Xiangya Hospital, Central South University, Changsha 410008 China
    2 Department of Pharmacy, Hainan Hospital of Chinese People’s Liberation Army General Hospital
    3 National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University
  • Received:2025-05-16 Revised:2025-07-21 Published:2025-09-15 Online:2025-09-16
  • Contact: △E-mail: huqin2016@csu.edu.cn

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摘要：

目的 探讨使用哌拉西林他唑巴坦（PTZ）治疗后发生低钾血症的危险因素，为临床安全用药提供参考。方法 回顾性选取1 355例使用PTZ治疗的住院患者，根据患者使用PTZ后是否发生低钾血症分为低钾血症组（血清钾<3.5 mmol/L，374例）和非低钾血症组（血清钾≥3.5 mmol/L，981例）。收集并比较2组患者的临床资料，采用多因素Logistic回归分析哌拉西林他唑巴坦致低钾血症的影响因素。结果 低钾血症组中轻度低钾血症308例（82.3%），中度63例，重度3例，中重度发生率为4.9%，最低血清钾浓度为2.1 mmol/L。低钾血症组女性比例、疗程、累积剂量、年龄校正查尔森合并症指数（aCCI）、血小板计数（PLT）<100×109/L比例、合并使用糖皮质激素比例均高于非低钾血症组（P<0.05），而基线血清钾、红细胞计数（RBC）均低于非低钾血症组（P<0.05）。多因素Logistic回归分析结果显示，女性，累积剂量、aCCI升高，较低的基线血清钾水平是哌拉西林他唑巴坦致低钾血症的危险因素（P<0.05）。结论 女性、基线血清钾水平较低、大剂量长疗程使用PTZ、高aCCI是PTZ致低钾血症的危险因素，应重点监测该类人群用药期间血清钾水平变化，保障患者用药安全。

关键词: 低钾血症, 哌拉西林/他唑巴坦复方合剂, 药物相关性副作用和不良反应, 危险因素, 女性, 年龄校正查尔森合并症指数

Abstract:

Objective To analyze risk factors of hypokalemia after treatment with piperacillin-tazobactam (PTZ) and to provide a reference for safe clinical medication. Methods A retrospective collection of 1 355 inpatients treated with PTZ was conducted. Patients were assigned to the hypokalemia group (serum potassium < 3.5 mmol/L, 374 cases) and the non-hypokalemia group (serum potassium ≥ 3.5 mmol/L, 981 cases) based on whether they suffered from hypokalemia after PTZ treatment. Clinical data were collected and compared in both groups of patients. Multifactorial Logistic regression analysis was used to identify the influencing factors of hypokalemia induced by PTZ. Results In the hypokalemia group, there were 308 cases of mild hypokalemia (82.3%), 63 cases of moderate hypokalemia and 3 cases of severe hypokalemia. The incidence of moderate to severe hypokalemia was 4.9%, with the lowest serum potassium concentration recorded at 2.1 mmol/L. The proportion of females, treatment duration, cumulative dosage, age-adjusted Charlson Comorbidity Index ( aCCI )，the percentage of patients with platelets (PLT) <100×109/L and the proportion of patients using glucocorticoids were all higher in the hypokalemia group than those of the non-hypokalemia group (P<0.05). Conversely, baseline serum potassium levels and red blood cell (RBC) were lower in the hypokalemia group than those of the non-hypokalemia group (P<0.05). Multivariate Logistic regression analysis indicated that female, increased cumulative dosage, elevated aCCI and lower baseline serum potassium concentration were risk factors for PTZ induced hypokalemia (P<0.05). Conclusion Female, lower basline serum potassium level, long-term high-dose use of PTZ and high comorbidity index are risk factors for the occurrence of PTZ-induced hypokalemia. The changes in serum potassium during the medication period of this type of patients should be closely monitored to ensure the safety of drug use for patients.

Key words: hypokalemia, piperacillin, tazobactam drug combination, drug-related side effects and adverse reactions, risk factors, femininity, age-adjusted Charlson comorbidity index

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