利奈唑胺相关血小板减少症及其影响因素分析  

Analysis of the effect factors of thrombocytopenia associated with linezolid

作　　者：刘晓[1,2] 梁雁[1] 李静姿[1] 刘亚欧[1] 谢秋芬[2] 孔妍 孙刘阳[2] 崔一民[1,2] 

机构地区：[1]北京大学第一医院药剂科,北京100034 [2]北京大学药学院药事管理与临床药学系,北京100191

出　　处：《中国新药杂志》2013年第10期1222-1227,共6页Chinese Journal of New Drugs

摘　　要：目的:重点关注利奈唑胺引起血小板减少的发生率及相关因素,同时关注患者用药后出现的与利奈唑胺相关的其他不良反应,为安全合理用药提供参考。方法:采用病例回顾性研究,通过我院HIS系统获得2009年1月-2012年12月使用利奈唑胺注射液或片剂治疗的全部住院患者。观察患者人口学资料、血常规、血生化、利奈唑胺用法用量等数据,采用SPSS 14.0统计学软件依变量性质对各项指标进行统计学分析。比较出现血小板减少症与未出现血小板减少症的组间差异,再对P<0.1的观察指标进行逐步Lo-gistic回归分析,筛选血小板减少症的相关危险因素。结果:共纳入有效病例407例。发生利奈唑胺相关血小板减少症者183例(44.96%),其中男性116例(63.39%),女性67例(36.61%)。血小板减少症开始发生中位时间为4.5 d(1 d,24 d)。血小板最低值出现中位时间为9 d(1 d,25 d)。比较血小板减少症发生组与未发生组患者的观察指标,结果显示用药前红细胞计数、血红蛋白浓度、白蛋白、血小板计数、直接胆红素、总胆红素、血肌酐、尿素、是否患有血液病、是否合并使用其他抗菌药共10项指标在2组间差异有统计学意义(P<0.05)。对上述P<0.1的观察指标进行逐步Logistic回归分析,结果显示用药前白蛋白浓度、血小板计数、是否联合使用其他抗菌药3个指标为血小板减少症的影响因素。结论:利奈唑胺引起血小板减少的发生率远高于其药品资料,应引起临床足够重视。特别是对基础血小板值低于正常值,血液病、肾功能不全,或高龄患者应用时应严密监测血常规指标。同时应注意疗程,并尽量避免联合使用其他可能导致血液系统损害的药物。如临床必需,应严格监测患者血液学指标,必要时给予停药及对症处理。Objective： To focus on the incidence and effect factors of thrombocytopenia associated with lin- ezolid. And pay attention to other adverse reactions associated with linezolid to provide reference for rational drug use. Methods： It was a retrospective study of patients treated with linezolid injection or tablets during January 2009 - December 2012. Data were absorbed by our HIS system. Observing patient demographic data, blood routine test, blood biochemistry, linezolid usage data, and used SPSS 14.0 statistical software to analyze. Compare the difference between the 2 groups of patients who occurred thrombocytopenia or no, and observe the index of P 〈 0.1 by stepwise Logistic regression analysis to screen the related risk factors of thrombocytopenia. Results： It containeda total of 407 valid cases. Linezolid associated thrombocytopenia occurred in 183 cases（44.96% ）. 116 cases were male （63.39%） and 67 cases were female （36.61%）. Thrombocytopenia occurs for a median of 4.5 d （1 d, 24 d）. Platelet minimum values occurred for a median of 9 d （1 d, 25 d）. Compared the 2 groups of patients who occurred thrombocytopenia or no, the results showed that the red blood cell count, hemoglobin concentration, platelet count, albumin, total bilirubin, direct bilirubin, serum creatinine, urea before treatment, whether suffer- ing from blood diseases, whether complicated with other antibacterial drugs 10 indicators had a statistically signifi- cant difference between the 2 group （P 〈 0.05）. Observed indexes of the P 〈 0.1 by stepwise Logistic regression analysis, the results showed that albumin concentration, platelet count before treatment, whether combined with other antibacterial drugs 3 index were the influence factors of thrombocytopenia associated with linezolid. Conclu- sion： The incidence of linezolid induced thrombocytopenia was far higher than that of the product information, which should be payed enough attention. Especially patients whose base platelet value was below the normal

关 键 词：利奈唑胺 血小板减少症 影响因素 不良反应 

分 类 号：R978.1[医药卫生—药品]