Abstract

Knowledge regarding the association between hypofibrinogenemia and tigecycline is based mainly on case reports. However, the clinical features of tigecycline-induced hypofibrinogenemia are unclear. We collected 20 patients (16 males and 4 females) with tigecycline-induced hypofibrinogenemia by searching the Chinese and English databases from June 2005 to May 2021, with a median age of 63.5 years (range 39∼90 years). Hypofibrinogenemia developed at a median of 9 days (range 2∼35 days). Most patients had no typical clinical manifestations, and only a few patients had bleeding and ecchymosis. Fibrinogen levels gradually decreased from 3.98 ± 2.05 g/L to 0.87 ± 0.45 g/L (P = 0.000), and the activated partial thromboplastin time (APTT) increased from 38.26 ± 8.80 s to 83.43 ± 47.23 s (P = 0.002). Fibrinogen levels in all patients recovered to the normal range within a median of 4 days (range 1∼12 days) after tigecycline cessation. Our results suggest that fibrinogen levels should be closely monitored in patients treated with tigecycline, specifically patients who may have renal insufficiency or patients with long-term use.

摘要

关于低纤维蛋白原血症和替加环素之间关联的知识主要基于病例报告。然而，替加环素引起的低纤维蛋白原血症的临床特征尚不清楚。我们通过检索2005年6月至2021年5月的中英文数据库，收集了20例（男16例，女4例）替加环素引起的低纤维蛋白原血症患者，中位年龄63.5岁（范围39～90岁）。低纤维蛋白原血症的发生时间平均为 9 天（范围 2∼35 天）。多数患者无典型临床表现，仅少数患者有出血、瘀斑。纤维蛋白原水平从 3.98 ± 2.05 g/L 逐渐下降至 0.87 ± 0.45 g/L ( P  = 0.000)，活化部分凝血活酶时间 (APTT) 从 38.26 ± 8.80 s 增加至 83.43 ± 47.23 s ( P = 0.000) 。 = 0.002）。所有患者的纤维蛋白原水平在替加环素停药后中位 4 天（范围 1∼12 天）内恢复到正常范围。我们的结果表明，应密切监测接受替加环素治疗的患者的纤维蛋白原水平，特别是可能患有肾功能不全的患者或长期使用的患者。