美罗培南致血小板升高2例  

Two cases of increased platelets induced by meropenem

作　　者：胡戴[1] 邓艾平[1] HU Dai;DENG Ai-ping(The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430014, China)

机构地区：[1]华中科技大学同济医学院附属武汉中心医院,湖北武汉430014

出　　处：《中国药物应用与监测》2017年第2期126-128,共3页Chinese Journal of Drug Application and Monitoring

摘　　要：病例1:患者,男性,53岁,因黄疸1月余行开腹"肝叶切除术+胆囊切除术+胆道探查术",术后给予常规预防切口感染、护肝护胃等对症支持治疗,术后5 d胆汁引流液培养出肺炎克雷伯(ESBL阳性),查血WBC 14.47×10~9·L^(-1),PLT 253×10~9·L^(-1);静脉使用美罗培南(1.0 g,q 8 h)抗感染,治疗10 d后PLT 779×10~9·L^(-1),服用阿司匹林肠溶片(100 mg,qn)4 d后PLT 644×10~9·L^(-1),停用阿司匹林和美罗培南3 d后PLT 480×10~9·L^(-1),停用15 d后PLT 237×10~9·L^(-1)。病例2:患者,男性,59岁,因"间断胸痛20 d,咳嗽10 d伴发热7 d"入院,入院时WBC 18.85×10~9·L^(-1),PLT 248×10~9·L^(-1),给予化痰平喘对症支持治疗,静脉滴注美罗培南(2.0 g,q 8 h)和利奈唑胺(0.6 g,q 12 h)抗感染,治疗10 d后PLT 666×10~9·L^(-1),美罗培南剂量减半使用5 d后PLT 448×10~9·L^(-1),停用美罗培南13 d后PLT 217×10~9·L^(-1)。Case1:A53-year-old male patient was conducted a lobectomy of liver and cholecystectomy and bile duct exploration surgery for jaundice over a month.With antimicrobial treatment for sanitation of surgical site infects,liver and stomach protective drugs were prescribed to ease the symptoms.On the fifth day after surgery,Klebsiella pneumoniae(ESBL positive)was found in the bile from the patient with WBC of14.47×109·L-1,PLT of253×109·L-1.To resist bacterial infection effectively,meropenem(1.0g,q8h)was administered intravenously.After treatment of meropenem for10days,PLT rose up to779×109·L-1,then fell to644×109·L-1after taking aspirin enteric-coated tablets for4days.Considering the infection condition relieved,PLT was counted at480×109·L-1and237×109·L-1,with aspirin and meropenem withdrawn for3days and15days,respectively.Case2:A59-year-old malepatient was admitted to hospital due to chest pain for20days intermittently,cough for10days and fever for7days,blood routineexamination showed WBC of18.85×109·L-1,PLT of248×109·L-1.For symptomatic treatment,expectorant and antiasthmatic wereused,and meropenem(2.0g,q8h)and linezolid(0.6g,q12h)were prescribed intravenously for infection.The PLT rose up to666×109·L-1after treatment of meropenem for10days.Due to adjustment of the dosage of meropenem to half for5days,PLT was448×109·L-1,which declined back to217×109·L-1after meropenem being quitting for13days.

关 键 词：美罗培南 血小板升高 药品不良反应 

分 类 号：R978[医药卫生—药品]