利奈唑胺治疗耐多药结核病致严重贫血1例  

Treating multi-drug resistant tuberculosis caused severe anemia by using Linezolid:a case report

作　　者：汪慧芳 杨江华 Wang Huifang;Yang Jianghua(Yijishan hospital,the first affiliated hospital of Wannan Medical College,Wuhu,Anhui,241000,China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院,安徽芜湖241000

出　　处：《齐齐哈尔医学院学报》2023年第3期239-242,共4页Journal of Qiqihar Medical University

摘　　要：目的探讨利奈唑胺治疗耐多药结核病的疗效和安全性。方法回顾性分析利奈唑胺治疗耐多药结核病致严重贫血病例1例,结合文献对利奈唑胺对耐多药结核病的临床疗效,贫血等血液系统不良反应发生情况、防治方法等进行分析。结果患者因治疗耐药结核病服用利奈唑胺0.6 g,1天2次,用药58天后出现严重贫血,血红蛋白48 g/L。停药,给予输注悬浮红细胞8U对症支持治疗,血红蛋白升高至108 g/L,利奈唑胺减量至0.3 g,1天1次,继续抗结核治疗。随访患者2个多月,复查血红蛋白131 g/L,利奈唑胺调整至0.6 g,1天1次,继续随访患者2个多月,患者血红蛋白122 g/L,结核病情控制稳定。结论耐药结核病需要长疗程使用利奈唑胺,利奈唑胺所致贫血是血液系统常见的严重不良反应,用药过程中应及时监测血常规调整剂量,保障治疗效果的同时保障患者用药安全。Objective To investigate the efficacy and safety of linezolid in the treatment of multi-drug resistant tuberculosis.Methods A case of severe anemia caused by multi-drug resistant tuberculosis that was treated with linezolid was analyzed retrospectively,and the clinical efficacy of linezolid in the treatment of multi-drug resistant tuberculosis,the occurrence of anemia and other adverse reactions in the blood system,the prevention and treatment methods were analyzed in combination with the literature.Results The patient orally took linezolid 0.6 g twice a day for the treatment of drug-resistant tuberculosis.After 58 days of treatment,he developed severe anemia with hemoglobin of 48 g/L.Then the drug administration was stopped,and 8U suspension red blood cells were infused for symptomatic support treatment.Until the hemoglobin increased to 108 g/L,linezolid decreased to 0.3 g,once a day,and anti-tuberculosis treatment was continued.The patient was followed up for more than 2 months,the hemoglobin was 131 g/L,and linezolid was adjusted to 0.6 g again,once a day.The patient was followed up for another more than 2 months,the hemoglobin of the patient was 122 g/L,and the tuberculosis condition was controlled stably.Conclusions Drug resistant tuberculosis needs a long course of treatment with linezolid.Anemia caused by linezolid is a common serious adverse reaction in the blood system.During the course of medication,the dose should be adjust according to blood routine monitoring,so as to ensure the treatment effect and drug safety for patients.

关 键 词：利奈唑胺 耐药结核病 贫血 用药安全 

分 类 号：R521[医药卫生—内科学]