老年患者使用利奈唑胺的临床评价及不良反应监测  

Clinical evaluation of linezolid and monitoring of adverse reactions in elderly patients

作　　者：李佳[1,2] 罗慧敏[3] 范玉华[3] 陈杰[1] 陈孝[1] 

机构地区：[1]中山大学附属第一医院药学部,广州510080 [2]中山大学药学院,广州510006 [3]中山大学中山医学院药理学教研室,广州510080

出　　处：《中国新药杂志》2017年第11期1322-1327,共6页Chinese Journal of New Drugs

摘　　要：目的:综合评价某综合教学医院老年住院患者使用利奈唑胺的临床合理性及其疗效和安全性。方法:采用回顾性研究方法,选取广州市某三甲医院2015年1月—2015年12月使用利奈唑胺注射剂或片剂的老年患者病例,根据药品说明书和相关指南,分析利奈唑胺的应用情况,并统计有效率及不良反应发生率。结果:共纳入有效病例55例(65~94岁),评价结果合理的有45例(81.81%),不合理的有10例(18.18%);治疗结果痊愈28例(50.91%),显效14例(25.45%),进步5例(9.09%),无效8例(14.54%)。用药后出现不良反应的有21例(38.18%),其中血小板减少19例(34.55%),白细胞减少4例(7.27%),血红蛋白减少3例(5.45%),恶心、呕吐3例(5.45%),腹泻2例(3.64%),皮疹1例(1.82%),乳酸性酸中毒1例(1.82%)。ICU患者血小板减少症的发生率明显高于非ICU患者(P=0.038),但不同剂型间的发生率无明显差异(P=0.512)。结论:利奈唑胺治疗老年患者革兰阳性球菌感染的疗效较好,但发生血小板减少的比例较高,尤其是ICU患者,值得临床关注。Objective ： To appraise the rationality of clinical use of linezolid in a general teaching hospital, as well as its efficacy and safety. Methods： A retrospective study was performed in elderly patients treated with LZD injection or tablets between January 2015 and December 2015 at a tertiary hospital in Guangzhou. The app the lication of linezolid and the effective rate and incidence of adverse reactions （ADR） were analyzed, referring to drug instruction and relevant guidelines. Results： Among the 55 patients included （65 -94 years old） , there were 45 cases for rational use （81. 81%）, 10 cases unreasonable （18. 18%）; 28 patients were cured （50.91%）, 14 effected （25.45%）, 5 improved （9.09%）, while8 invalid （14.54%）. In21 cases （38.18%） observed ADR after medication, 19 suffered from thrombocytopenia （34.55%）, white blood cell reduced in 4 cases （7.27%） , hemoglobin decreased in 3 cases （5.45%） , 3 of nausea and vomiting （5.45%） , 2 of diarrhea （3.64%）, 1 of skin rash （ 1.82% ）, and 1 of lactic acidosis （ 1. 82% ）. The incidence of thrombocytopenia in patients with ICU was significantly higher than that in non-ICU （P = 0. 038）, but there was no statistical significance between different dosage forms （P =0. 512）. Conclusion： Linezolid is effective in the treatment on Gram-positive bacteria infections especially in ICU, in the elderly patients. However, research shows that it has high rate of thrombocytopenia, which worth more clinical attention in future practice.

关 键 词：利奈唑胺 老年患者 合理用药 不良反应 血小板减少症 

分 类 号：R978[医药卫生—药品]