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| Study on the Correlation between Doxycycline Blood Concentration and Coagulation Function Indicators in Patients with Severe Pulmonary Infection |
| Zhang Pei, Li Nan, Han Jialin |
| Department of Pharmacy,Zhengzhou First People's Hospital,Zhengzhou,Henan 450000,China |
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Abstract Objective To explore the correlation between doxycycline steady-state blood drug concentration and coagulation function indicators in patients with severe pulmonary infections,providing a basis for clinical individualized medication. Method A total of 110 patients with severe pulmonary infections admitted to our ICU from January 2023 to January 2025 were prospectively included and divided into an observation group(n=60)and a control group(n=50)based on whether doxycycline was used or not.On the third day of administration,the observation group measured the steady-state peak concentration(C0)and trough concentration(C0),and dynamically monitored the prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),international normalized ratio(INR),and platelet count(PLT)of both groups before treatment and on the third and seventh days of treatment.Pearson correlation and multiple linear regression were used to analyze the relationship between blood drug concentration and coagulation indicators. Result On the third day of treatment,PT,APTT,and INR in the observation group significantly increased compared to baseline(P<0.05),while FIB and PLT significantly decreased(P<0.05).On the seventh day,they returned to baseline levels;There was no significant difference in the indicators of the control group before and after treatment(P>0.05).The observation group's doxycycline C2 was(3.28±1.15)μg/mL,and C0 was(1.46±0.62)μg/mL.C2is significantly positively correlated withΔPT,ΔAPTT,and ΔINR(r=0.582,0.517,0.603,P<0.001),and significantly negatively correlated with ΔFIB and ΔPLT(r=-0.493,-0.446,P<0.01);There is no significant correlation between C0 and various indicators.Multiple regression analysis showed that doxycycline C0(β=0.412),combined use of cefoperazone sulbactam(β=0.306),and baseline APTT prolongation(β=0.251)were independent risk factors for PT elevation(P<0.05). Conclusion Doxycycline can cause transient coagulation dysfunction in patients with severe pulmonary infections,with the degree of impact significantly correlated with the steady-state peak concentration.When C0>3.95 μg/mL,the risk of coagulation dysfunction increases significantly.It is recommended to monitor blood drug concentrations clinically and avoid concomitant use with cefoperazone-sulbactam.
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Received: 04 March 2026
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[1] 时绘绘,李进,袁耀辉.1例多西环素联合羟氯喹治疗疑诊惠普尔养障体肺部感染的药学监护[J].中南药学,2025,23(12):3742-3745. [2] 周树根. 多西环素应用于大环内酯类耐药肺炎支原体肺炎患儿的临床效果分析[J].现代医学与健康研究电子杂志,2025,9(18):40-42. [3] 杜梅,谭瑞娟,王立丹,等.多黏菌素B联合其他抗菌药物治疗CRAB肺部感染临床效果的影响因素研究[J].中国药房,2025,36(12):1495-1499. [4] 曾华彪,陈丽芳.多西环素联合阿奇霉素对恙虫病合并肺部感染疗效分析[J].中华灾害救援医学,2024,11(11):1294-1297. [5] 张云琛,黄文辉,蔡贵艳,等.蜃楼弗朗西斯菌血流感染1例及文献复习[J].中国感染控制杂志,2024,23(10):1302-1306. [6] 冼雪梅,邵景天.麻杏石甘汤联合多西环素治疗肺病高热患者的疗效观察[J].中华养生保健,2024,42(01):20-23. [7] 任俊丽,彭芳辰,周煊平,等.替加环素不同联合治疗方案治疗耐碳青霉烯鲍氏不动杆菌肺部感染的临床疗效及安全性[J].中华医院感染学杂志,2024,34(01):18-22. [8] 梁光辉,张克昌,张国良.TEG联合凝血功能对重症肺部感染患者病情程度及预后的评估价值[J].中南医学科学杂志,2023,51(05):778-780. [9] 郑民洁,张博.多西环素联合乙酰半胱氨酸序贯疗法治疗老年支原体肺炎的临床观察[J].医学理论与实践,2023,36(14):2400-2402. [10] 苏旸,杨玲,李园园,等.二甲双胍/多西环素复合微球的制备及其抗Ⅱ型糖尿病合并肺感染的初步研究[J].中国抗生素杂志,2023,48(05):538-546. [11] 郭玲玲,刘娜,周洪,等.鹦鹉热衣原体肺炎10例临床特征分析及诊治[J].中国感染与化疗杂志,2022,22(05):551-555. [12] 陈肖,陈朴,林媛媛,等.老年重症耐甲氧西林金黄色葡萄球菌感染患者替考拉宁的药动学研究和药效学评价[J].中国现代应用药学,2022,39(11):1478-1483. [13] 邵景天,黄艳,黄丽娴.多西环素联合哌拉西林舒巴坦治疗社区获得性肺炎高热患者的临床观察[J].现代医院,2022,22(05):800-802. [14] 邵景天,黄艳,黄丽娴.多西环素治疗肺部感染发热患者感染指标的临床观察[J].哈尔滨医药,2022,42(02):14-16. [15] 王敏,杨娜,罗雪梅,等.重症患者替加环素血药浓度与凝血指标相关性研究[J].中国药师,2021,24(11):2058-2061. [16] 毛丽燕,冯建.呼吸内科重症感染患者降钙素原和凝血功能及其与预后的关系[J].中华医院感染学杂志,2021,31(20):3130-3134. [17] 金刚,周倩倩,王文昊,等.替加环素治疗老年泛耐药鲍曼不动杆菌肺部术后感染的临床分析[J].中华肺部疾病杂志(电子版),2021,14(04):469-471. [18] 时薛丽,范明辉,谢凤杰,等.利奈唑胺血药浓度波动影响因素及不良反应分析[J].中国现代医生,2021,59(18):114-116+137. [19] 韦秀平,王娟,龙剑海.老年肺部感染患者不同剂量去甲万古霉素谷浓度分析[J].中国临床药理学杂志,2021,37(11):1311-1314. [20] 洪丽明,李乐辉,田秘,等.亚胺培南治疗肺炎克雷伯菌肺部感染的药代动力学及其与临床疗效的关系[J].中华医院感染学杂志,2021,31(09):1343-1347. |
| [1] |
Wang Yitong, Zhao Zilu, Lu Mingyang. Dynamic Monitoring of Coagulation Function and Individualized Blood Component Transfusion Strategy in Patients Undergoing Massive Transfusion[J]. journal1, 2026, 46(4): 41-44. |
| [2] |
Wang Hao, He Yanxiang, Li Haixiao. Clinical Value of Dipyridamole Combined with Standard Regimen in the Treatment of Kawasaki Disease in Children[J]. journal1, 2025, 45(4): 46-48. |
| [3] |
. [J]. journal1, 2025, 45(4): 58-60. |
| [4] |
. [J]. journal1, 2025, 45(3): 62-65. |
| [5] |
Zhang Haitao, Zhang Qihang, Lu Linjun. To Evaluate the Therapeutic Effect of Low Molecular Weight Heparin on Recurrent Abortion Susceptibility Based on Coagulation Function and Platelet Level[J]. journal1, 2025, 45(1): 4-4. |
| [6] |
. [J]. journal1, 2025, 45(1): 124-126. |
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