利奈唑胺致乳酸酸中毒研究进展  

Research progress of linezolid-induced lactic acidosis

作　　者：张乃菊[1] 陈天平[2] 黄睿[3] 陈重[3] 张帆[3] 孔令提[1] 夏娟[3] 刘金春[4] ZHANG Naiju;CHEN Tianping;HUANG Rui;CHEN Zhong;ZHANG Fan;KONG Lingti;XIA Juan;LIU Jinchun(Department of Pharmacy the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,Anhui,China;Department of Cardiovascular Medicine,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,Anhui,China;Department of Infection,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,Jiangsu,1China;Department of Pharmacy,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,Jiangsu,China)

机构地区：[1]蚌埠医学院第一附属医院药剂科,安徽蚌埠233004 [2]蚌埠医学院第一附属医院心血管科,安徽蚌埠233004 [3]南京大学医学院附属鼓楼医院感染科,江苏南京210008 [4]南京大学医学院附属鼓楼医院药学部,江苏南京210008

出　　处：《中国临床药理学与治疗学》2020年第12期1408-1413,共6页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：蚌埠医学院转化医学重点项目(BYTM2019015)。

摘　　要：利奈唑胺是噁唑烷酮类抗菌药物,用于耐甲氧西林金黄色葡萄球菌、青霉素耐药肺炎链球菌和耐万古霉素肠球菌等革兰阳性球菌引起的感染。乳酸酸中毒是利奈唑胺的不良反应之一。利奈唑胺致乳酸酸中毒的危险因素为长时间暴露、肝功能障碍、肾功能障碍、线粒体DNA A2706G多态性、合并使用影响线粒体功能的药物等。利奈唑胺引起乳酸酸中毒的症状为恶心、呕吐、嗜睡、呼吸急促、心动过速和血压下降等,可通过密切监测血乳酸、p H、血药浓度等实验室指标以早期识别。利奈唑胺引起乳酸酸中毒机制可能与线粒体毒性相关。利奈唑胺发生乳酸酸中毒可通过减少药物剂量、停药甚至体外肾脏替代治疗,必要时加强对症支持治疗。本文对此开展综述,以期为临床防治利奈唑胺致乳酸酸中毒提供思路。Linezolid is an oxazolidinone antibacterial agent used in infections caused by grampositive cocci such as methicillin-resistant staphylococcus aureus,penicillin-resistant pneumococcus and vancomycin-resistant enterococcus.Lactic acidosis is one of the adverse reactions of linezolid.The risk factors of lactic acidosis caused by linezolid are long-term exposure,liver dysfunction,renal dysfunction,mitochondrial DNA A2706G polymorphism,combined use of drugs affecting mitochondrial function,etc.The symptoms of lactic acidosis caused by linezolid are nausea,vomiting,drowsiness,shortness of breath,tachycardia,and hypotension,etc.,which can be identified early by close monitoring of laboratory indicators such as blood lactic acid,p H,and blood drug concentration.The mechanism of lactic acidosis induced by linezolid may be related to mitochondrial toxicity.The lactic acidosis of linezolid can be caused by reducing drug dose,stopping drug or even in vitro renal replacement therapy,and strengthening symptomatic support therapy if necessary.This review is intended to provide ideas for the clinical prevention and treatment of lactate acidosis caused by linezolid.

关 键 词：利奈唑胺 乳酸酸中毒 不良反应 治疗措施 

分 类 号：R99[医药卫生—毒理学]