Risk factors for the development of auditory toxicity in patients receiving aminoglycosides.
Risk factors for the development of auditory toxicity in patients receiving aminoglycosides.
复制标题
接受氨基糖苷类药物治疗的患者发生听觉毒性的危险因素。
DOI：
--
复制
发表时间：
1984
影响因子：
6.4
通讯作者：
P. Lietman
中科院分区：
文献类型：
--
作者：
R. Moore;Craig R. Smith;P. Lietman
通过对参加三项庆大霉素、妥布霉素和阿米卡星的前瞻性、随机、双盲临床试验的 135 名患者进行分析，确定了接受氨基糖苷类药物治疗的患者发生听觉毒性的危险因素。 30 名患者 (22.3%) 出现听觉毒性，定义为听觉敏锐度下降大于或等于 15 dB。患有听觉毒性的患者接受治疗的时间较长，更有可能出现菌血症，并且平均体温较高（P 小于 0.05）。使用逐步判别分析，我们选择了这些具有肝功能障碍的因素以及血清尿素氮：血清肌酐比，以准确区分中毒和非中毒患者。对方程的预测准确性没有显着影响的因素包括血浆氨基糖苷类药物水平、氨基糖苷类药物类型、速尿使用、糖尿病、年龄、性别、肾功能、初始听力敏锐度、血细胞比容值和休克。该分析对于确定听觉毒性的病理生理学和临床试验中接受氨基糖苷类药物的患者的预后分层可能很重要。
Risk factors for the development of auditory toxicity in patients receiving aminoglycosides were determined from the analysis of 135 patients enrolled in three prospective, randomized, double-blind clinical trials of gentamicin, tobramycin, and amikacin. Auditory toxicity, defined as a decrease in auditory acuity of greater than or equal to 15 dB, occurred in 30 patients (22.3%). Patients with auditory toxicity underwent therapy for a longer period, were more likely to be bacteremic, and had, on the average, a higher temperature (P less than 0.05). Using stepwise discriminant analysis, we selected these factors with liver dysfunction and the serum urea nitrogen:serum creatinine ratio in a function that accurately discriminates between toxic and nontoxic patients. Factors not adding significantly to the predictive accuracy of the equation were plasma aminoglycoside levels, aminoglycoside type, furosemide use, diabetes, age, sex, renal function, initial auditory acuity, hematocrit value, and shock. This analysis may be important both for determining the pathophysiology of auditory toxicity and for the prognostic stratification of patients receiving aminoglycosides in clinical trials.