关键词: 药物性肝损伤, 感染, 替加环素, 治疗, 老年人

Abstract: Objective The aim of this study was to retrospectively summarize the clinical feature of drug(tigecycline)-induced liver injuries (DILI) in 134 elderly patients with infection and underlying diseases. Methods The clinical materials of 134 elderly patients with DILI caused tigecycline administration between 2018 and 2020 were summarized retrospectively. The underlying diseases, pathogens and liver function tests were analyzed. Results Among the 134 patients, 54.5% were males and 45.5% were females, with 41.8% of them younger than 70 years old and 58.2% older than 70 years old; the patients hospitalized in Intensive Care Unit, Department of Respiratory Diseases and Department of Orthopaedics accounted for 34.3%, 28.4% and 16.4%; as to the underlying diseases, the hypertension accounted for 67.9%, diabetes for 25.4%, malignant tumors for 23.1%, coronary heart disease for 14.2%, chronic obstructive pulmonary disease for 11.2% and bone fracture for 7.5%; the concomitant administration of cefoperazone/sulbactam accounted for 94.8%; the infected sites included pulmonary, bone and joint, and abdominal cavity infection for 49.3%, 23.1% and 13.4%; the Klebsiella Pneumoniae, Acinetobacter Baumannii and Stenotrophomonas Maltophilia infections accounted for 32.8%, 24.6% and 17.2%; the liver function tests were abnormal one week after intravenous tigecycline administration and peaked at two weeks, with serum bilirubin level of(35.2±5.9)μmmol/L, aspartate aminotransferase level of (69.1±11.5)U/L, alanine aminotransferase level of (56.4±9.3)U/L, alkaline phosphatase level of (194.8±29.3)U/L and acyltranspeptidase level of (134.6±18.9)U/L, which decreased to (29.1±5.0)μmmol/L, (57.9±9.6)U/L, (50.2±8.6)U/L, (183.3±27.4)U/L and (126.9±15.4)U/L one week after discontinuation of tigecycline; the liver function tests returned to normal at day 5 to 33 days, with the average time of (14.6±2.3)days; 130 patients recovered, 3 discharged with abnormal liver function tests and 1 died of multi-organ failures in our series. Conclusion The intravenous administration of tigecycline in treating elderly patients with various infections could cause liver damage, and the surveillance of liver function tests is of particularly importance.

Key words: Drug-induced liver injuries, Infection, Tigecycline, Therapy, Elderly