利奈唑胺致血液系统不良反应的回顾性研究  

Retrospective Study of Adverse Drug Reaction (ADR) Induced by Linezolid in Hematological System

作　　者：朱熙[1] 刘丽萍[1] 胡伟[1] 杨婷[1] 杨雅茹[1] 

机构地区：[1]安徽医科大学第二附属医院药剂科,合肥230601

出　　处：《医药导报》2017年第5期579-583,共5页Herald of Medicine

基　　金：安徽医科大学校科学研究基金资助项目(2015xkj041)

摘　　要：目的探讨利奈唑胺所致血液系统不良反应的发生率及危险因素。方法采用回顾性研究方法,筛选出安徽医科大学第二附属医院各临床科室2012年1月—2015年12月接受利奈唑胺或万古霉素抗感染治疗的住院患者共124例。依据用药情况分为利奈唑胺组和万古霉素组各62例。观察利奈唑胺组患者血液系统不良反应的发生率及转归。将两组患者相关临床资料同时纳入单因素和多因素Logistic回归方程,分析血小板(PLT)和血红蛋白(Hb)减少的危险因素。结果利奈唑胺组发生PLT减少21例(33.87%),Hb减少17例(27.42%),未观察到患者因PLT或Hb减少停用利奈唑胺。多因素逐步回归分析显示,使用利奈唑胺[OR=7.699,95%CI(1.408,42.090),P=0.019]、疗程>14 d[OR=7.639,95%CI(1.162,50.226),P=0.034]、基础肾小球滤过率(e GFR)<80 m L·min-1[OR=6.150,95%CI(1.604,23.577),P=0.008]、基础白蛋白(ALB)<25 g·L^(-1)[OR=4.078,95%CI(1.017,16.351),P=0.047]及基础PLT<200×109·L^(-1)[OR=6.148,95%CI(1.705,22.172),P=0.006]为PLT减少的独立危险因素。使用利奈唑胺[OR=4.335,95%CI(1.308,14.365),P=0.016]和基础ALB<25 g·L^(-1)[OR=5.424,95%CI(1.824,16.129),P=0.002]为Hb减少的独立危险因素。结论利奈唑胺引起PLT和Hb减少的情况并不少见,但多可恢复正常。使用利奈唑胺时,应关注引起PLT和Hb减少的相关危险因素,注意监测血常规。Objective To investigate the incidence and risk factors of adverse drug reactions in hematological system induced by linezolid.Methods In this retrospective study, 124 inpatients treated with linezolid （n=62） or vancomycin （n=62） for anti-infective therapy between January 2012 and December 2015 in clinical departments of the Second Affiliated Hospital of Anhui Medical University were included.The incidence hematological adverse drug reactions were observed, and the single factor and the multiple factor Logistic regression methods were used to analyze the risk factors of developing thrombocytopenia and decline of hemoglobin.Results Among the 62 inpatients treated with linezolid, thrombocytopenia occurred in 21 patients（33.87%）, and decline of hemoglobin occurred in 17 patients （27.42%）.No patient discontinued the use of linezolid for the reason of thrombocytopenia or decline of hemoglobin.In multiple stepwise regression analysis, linezolid use[OR=7.699,95%CI （1.408,42.090）,P=0.019], treatment duration〉14 d[OR=7.639,95%CI（1.162,50.226）,P=0.034], baseline eGFR〈80 mL·min-1[OR=6.150,95%CI（1.604,23.577）,P=0.008], baseline ALB〈25 g·L-1[OR=4.078,95%CI（1.017,16.351）,P=0.047] and baseline platelet count〈200×109·L-1[OR=6.148,95%CI（1.705,22.172）,P=0.006] were independent risk factors for thrombocytopenia;linezolid use [OR=4.335,95%CI（1.308,14.365）,P=0.016] and baseline ALB〈25 g·L-1[OR=5.424,95%CI（1.824,16.129）,P=0.002] were independent risk factors for the decline of hemoglobin.Conclusion The incidences of thrombocytopenia and anemia induced by linezolid are not rare, and most of them can be returned to normal.The risk factors of thrombocytopenia and anemia should be concerned and the routine blood test should be monitored during use.

关 键 词：利奈唑胺 血小板 血红蛋白 不良反应 

分 类 号：R978[医药卫生—药品] R969.3[医药卫生—药学]