乙胺丁醇致血液系统不良反应8例  

Ethambutol-induced hematological adverse reactions:report of 8 cases

作　　者：肖科 姚建平 税雪姣 钟利 黄富礼 XIAO Ke;YAO Jianping;SHUI Xuejiao;ZHONG Li;HUANG Fuli(Department of Infectious Diseases,Department of Tuberculosis,Infection and Immunity Laboratory,Affiliated Hospital of Southwest Medical University,Luzhou Sichuan 646000,China)

机构地区：[1]西南医科大学附属医院感染病科,结核病科,感染与免疫实验室,四川泸州646000

出　　处：《中国感染与化疗杂志》2020年第5期536-539,共4页Chinese Journal of Infection and Chemotherapy

基　　金：四川省重点学科(传染病学)建设项目(SZD0421)。

摘　　要：目的了解乙胺丁醇导致血液系统不良反应的临床特点。方法收集2015年1月-2019年12月西南医科大学附属医院感染病科收治的因使用抗结核药物后出现药物不良反应患者的资料。统计分析由乙胺丁醇所致血液系统不良反应患者的临床资料。结果8例患者纳入研究,男6例,女2例,年龄39~65岁。用药后首次发生血液系统不良反应的时间7~30 d,以贫血及出血性疾病常见,其中血小板减少症3例,血小板减少性紫癜2例,贫血2例,累及关节和肾脏的过敏性紫癜1例。患者的血小板最低至39×10^9/L,血红蛋白最低至52 g/L,经停药、调整抗结核药物方案及对症治疗后均痊愈。结论乙胺丁醇可导致多种血液系统不良反应,临床应予以重视,及时调整抗结核药物方案及对症处理后多数患者预后良好。Objective To understand the clinical characteristics of hematological adverse reactions caused by ethambutol.Methods The data of patients with adverse drug reactions(ADRs)after treatment with antituberculosis drugs were collected from January 2015 to December 2019 in Department of Infectious Diseases,Affiliated Hospital of Southwest Medical University.The confirmed cases of ethambutol-induced hematological adverse reactions were analyzed statistically.Results A total of 8 patients were included in the study,including 6 males and 2 females,39 to 65 years of age.The onset time of hematologic adverse reactions was 7 to 30 days after administration of ethambutol.Anemia and hemorrhagic diseases were the common ADRs,including 3 cases of thrombocytopenia,2 cases of thrombocytopenic purpura,2 cases of anemia,and 1 case of allergic purpura involving joints and kidneys.The lowest platelet count was 39×10^9/L,and the lowest hemoglobin level was 52 g/L.All patients recovered after discontinuation of ethambutol,adjustment of anti-tuberculosis regimen,and symptomatic treatment.Conclusions Ethambutol can cause a variety of hematological adverse reactions,which should be taken seriously in clinical practice.The outcome is good in most cases after timely adjustment of antituberculosis regimen and symptomatic treatment.

关 键 词：乙胺丁醇 药物不良反应 贫血 血小板减少 紫癜 

分 类 号：R978.3[医药卫生—药品]