利奈唑胺联用5-羟色胺能药物致5-羟色胺综合征文献病例分析  

Literature case analysis of serotonin syndrome induced by combined use of linezolid and serotonergic drugs

作　　者：张云琛 黄文辉[1] 王芳芳[1] 孔令东 陈秋红[1] Zhang Yunchen;Huang Wenhui;Wang Fangfang;Kong Lingdong;Chen Qiuhong(Department of Pharmacy,No.909 Hospital of Joint Logistics Support Force/the Affiliated Southeast Hospital of Xiamen University,Fujian Province,Zhangzhou 363000,China;Department of Pharmacy,Hospital of Pinghe County,Fujian Province,Pinghe 363700,China)

机构地区：[1]联勤保障部队第九〇九医院/厦门大学附属东南医院药剂科,漳州363000 [2]福建省平和县医院药剂科,平和363700

出　　处：《药物不良反应杂志》2021年第9期480-486,共7页Adverse Drug Reactions Journal

摘　　要：目的了解利奈唑胺联用5-羟色胺能药物致5-羟色胺综合征(SS)的临床特征。方法检索国内外数据库(截至2021年2月),收集利奈唑胺联用5-羟色胺能药物致SS的病例报告类文献,记录患者基本情况(性别、年龄、基础疾病等)、利奈唑胺和5-羟色胺能药物用药情况(用药原因、用法用量、药物洗脱期等)以及SS的发生时间、临床表现、处置及转归等信息,进行描述性统计分析。结果纳入分析的患者共50例(来自46篇文献),男性23例,女性27例;年龄23~98岁49例,4岁1例;使用5-羟色胺能药物的原因为精神疾病(36例)、疼痛(8例)和帕金森病(2例)等,使用利奈唑胺的原因为葡萄球菌属感染(24例)、肠球菌属感染(13例)和经验性抗感染治疗(11例)等。50例患者中,先用5-羟色胺能药物再用利奈唑胺者48例,先用利奈唑胺再用5-羟色胺能药物者2例;44例无药物洗脱期记录,6例药物洗脱期不足。5-羟色胺能药物用药途径为口服者40例、静脉滴注者10例;35例患者有用法用量记录,均符合药品说明书规定;使用1、2、3、4种5-羟色胺能药物者分别为27、16、5、2例,所用药物主要为选择性5-羟色胺再摄取抑制剂、5-羟色胺能药物和去甲肾上腺素再摄取抑制剂、三环类抗抑郁药、阿片类药物等。利奈唑胺用药途径为静脉滴注者27例,口服者11例,未提及用药途径者12例;49例成人患者用药频次符合药品说明书规定,1例患儿用药频次低于药品说明书规定。SS发生于联合用药后3 h~20 d,多在联合用药后1~5 d;表现为精神状态改变、自主神经功能异常和神经肌肉功能异常者分别为45、47、45例。停用利奈唑胺和/或5-羟色胺能药物并接受对症治疗2 h~9 d后,43例好转,1例出现SS后因心脏骤停死亡,6例在SS症状得到控制后死于原发疾病。结论利奈唑胺联用5-羟色胺能药物致SS多发生在联合用药后1~5 d,临床表现与其他原因所致SS相似,停用相�Objective To understand the clinical characteristics of serotonin syndrome(SS)induced by combined use of linezolid and serotonergic drugs.Methods Relevant databases at home and abroad as of February 2021 were searched and case reports of SS induced by linezolid combined with serotonergic drugs were collected.Clinical information including patients′basic characteristics(gender,age,underlying disease,etc.),linezolid and serotonergic drugs application(medication reasons,usage and dosage,drug elution period,etc.),and the occurrence time,clinical manifestations,intervention measures,and outcomes of SS were extracted and analyzed by descriptive statistical method.Results A total of 50 patients derived from 46 literature were enrolled in the study,including 23 males and 27 females.Of them,49 patients were aged from 23 to 98 years,and one patient was 4 years old.The reasons for using serotonergic drugs were mental illness(36 patients),pain(8 patients),and Parkinson′s disease(2 patients),etc.;the reasons for using linezolid were staphylococcal infection(24 patients),enterococcal infection(13 patients),and empirical anti-infection treatments(11 patients),etc.Among the 50 patients,48 were treated with serotonergic drugs and then with linezolid,and 2 were treated with linezolid and then with serotonergic drugs;the drug washout period was not recorded in 44 patients and not long enough in the other 6 patients;the serotonergic drugs were given orally in 40 patients and by intravenous infusion in 10 patients;35 patients had usage and dosage records,which were all in line with the requirements of drug labels;27,16,5,and 2 patients were treated with 1,2,3,and 4 kinds of serotonergic drugs respectively,and the drugs used mainly were selective serotonin reuptake inhibitors,serotonergic drugs and norepinephrine reuptake inhibitors,tricyclic antidepressants,and opioids,etc.Except the administration route of linezolid was not mentioned in 12 patients,it was given by intravenous infusion in 27 patients and orally in 11 patients.The

关 键 词：单胺氧化酶抑制剂 5-羟色胺 5-羟色胺综合征 药物相关副作用和不良反应 利奈唑胺 

分 类 号：R969.3[医药卫生—药理学]