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引用本文:章媛,胡燕平,刘骏,阳平,陈娜.达托霉素致PT/INR异常升高的病例分析及文献复习[J].中国现代应用药学,2019,36(13):1682-1685.
ZHANG Yuan,HU Yanping,LIU Jun,YANG Ping,CHEN Na.Case Analysis and Literature Review of Daptomycin Induced Abnormal Prolongation of PT/INR[J].Chin J Mod Appl Pharm(中国现代应用药学),2019,36(13):1682-1685.
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达托霉素致PT/INR异常升高的病例分析及文献复习
章媛1,2, 胡燕平2, 刘骏3, 阳平1, 陈娜1
1.浙江大学附属第一医院, 药剂科, 杭州 310000;2.杭州市萧山区第三人民医院药剂科, 杭州 311251;3.浙江大学附属第一医院, 感染病科, 杭州 310000
摘要:
目的 提高对达托霉素(daptomycin,DAP)致凝血酶原时间/国际标准化比值(prothrombin time/international normalized ratio,PT/INR)假性升高的临床认识。方法 对1例使用DAP致PT/INR异常升高患者的临床资料进行回顾性分析,并复习相关文献。结果 本例患者PT/INR异常升高考虑为DAP与测定PT所用试剂间的相互作用而引起的假性升高,未予维生素K拮抗治疗,并及时加用华法林抗凝治疗,降低了患者发生血栓的风险。结论 随着耐药菌的出现,DAP在临床上的应用逐渐增多,应重视使用DAP时PT/INR异常升高的现象,特别是在接受华法林抗凝治疗的患者中应采用多种检测方法复测患者的凝血功能水平,减少因检测方法的缺陷导致临床治疗的失误。
关键词:  达托霉素  PT/INR  文献复习
DOI:10.13748/j.cnki.issn1007-7693.2019.13.017
分类号:R969.3
基金项目:2019年浙江省医药卫生科技计划项目(2019RC168);2016年浙江省药学会医院药学专项科研资助项目(2016ZYY03);2016年杭州市萧山区重大科技攻关项目(2016306);2019年杭州市卫生科技计划项目(OO20191053)
Case Analysis and Literature Review of Daptomycin Induced Abnormal Prolongation of PT/INR
ZHANG Yuan1,2, HU Yanping2, LIU Jun3, YANG Ping1, CHEN Na1
1.The First Affiliated Hospital of Zhejiang University, Department of Pharmacy, Hangzhou 310000, China;2.Department of Pharmacy, The Xiaoshan Third People's Hospital, Hangzhou 311251, China;3.The First Affiliated Hospital of Zhejiang University, Department of Infectious Diseases, Hangzhou 310000, China
Abstract:
OBJECTIVE To improve the clinical recognition of daptomycin induced artificial prolongation of prothrombin time/international normalized ratios(PT/INR). METHODS Clinical data of a case of daptomycin induced abnormal prolongation of PT/INR were retrospectively analyzed, and reviewed the literature. RESULTS Abnormal prolongation of PT/INR in this patient was considered to cause by daptomycin interacting with some test reagents of PT. Therefore, the patient didn't receive vitamin K therapy, and warfarin was added in time to reduce the risk of thromboembolic events. CONCLUSION With the emergence of drug-resistant bacteria, the clinical application of daptomycin is gradually increasing, abnormal prolongation of PT/INR in patients who treated with daptomycin should be paid more attention, especially for the warfarin users, coagulation function should be tested by other methods to decrease mistakes in clinical treatment due to defects in test methods.
Key words:  daptomycin  PT/INR  literature review
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