1例利奈唑胺致患者红细胞和血红蛋白减少、齿舌变色的病例分析  

Case Analysis of One Patient with Decreased RBC and Hemoglobin and Discoloration of Radula Caused by Linezolid

作　　者：孙晓慧 王继美 SUN Xiao-hui;WANG Ji-mei(Pharmacy Department,Dongying District People's Hospital,Dongying Shandong 257099,China;Pharmacy Department,Dongying People's Hospital,Dongying Shandong 257091,China)

机构地区：[1]东营市东营区人民医院药剂科,山东东营257099 [2]东营市人民医院药剂科,山东东营257091

出　　处：《抗感染药学》2023年第8期810-813,共4页Anti-infection Pharmacy

摘　　要：目的:分析利奈唑胺所致患者红细胞和血红蛋白减少、齿舌变色等药物不良反应的临床特点和处置过程,为临床利奈唑胺的安全、合理使用提供参考。方法:该患者因发热伴膝关节疼痛到院治疗,既往史显示患者近期大腿内侧距离膝盖10 cm处有破溃流脓的情况,CT检查显示存在膝关节积液,遂考虑为骨关节感染,予利奈唑胺治疗;但治疗过程中,患者的红细胞和血红蛋白水平进行性下降,且舌苔变黄、牙齿颜色变为浅棕色。结果:多学科专家会诊认为,红细胞和血红蛋白减少不排除为利奈唑胺所致的可能,当日患者办理出院同时停用利奈唑胺;1周后,患者来院复查,红细胞和血红蛋白水平恢复至3.54×10~(12)/L和100 g/L;2周后,患者的红细胞和血红蛋白水平恢复至4.22×10~(12)/L和121 g/L,舌苔和牙齿颜色趋于正常。结论:回顾患者病程,基本可以确认其红细胞和血红蛋白减少、齿舌变色等均为利奈唑胺所致,提示临床在用药过程中应加强对药物不良反应的敏感性和识别能力,以确保患者的用药安全。Objective:To analyze the clinical characteristics and treatment process of adverse drug reactions such as decrease in red blood cells(RBC)and hemoglobin and discoloration of radula caused by linezolid in patients,and provide reference for safe and rational use of linezolid clinically.Methods:The patient went to the hospital for treatment due to fever and knee joint pain.The past history showed that the patient had recently developed ulcers and pus on the inner thigh 10 cm away from the knee.The CT scan showed the presence of knee joint effusion,so it was considered to be a bone and joint infection.Linezolid was given for treatment;however,in the treatment process,the patient's RBC and hemoglobin levels decreased progressively,and his/her tongue coating turned yellow,and his/her teeth turned light brown.Results:Multidisciplinary expert consultation believed that the decrease in RBC and hemoglobin levels caused by linezolid could not be ruled out.The patient was discharged from the hospital on the same day and linezolid was discontinued;1 week later,the patient came to the hospital for review,and his/her RBC and hemoglobin levels returned to 3.54×1012/L and 100 g/L;2 weeks later,the patient's RBC and hemoglobin levels recovered to 4.22×1012/L and 121 g/L,and the color of tongue coating and teeth turned to normal.Conclusion:By reviewing the patient's disease course,it can be basically confirmed that the decrease in RBC and hemoglobin levels and the discoloration of radula are caused by linezolid,which suggests that sensitivity and identification ability of adverse drug reactions shall be strengthened during clinical medication to ensure the patient's medication safety.

关 键 词：利奈唑胺 药物不良反应 红细胞 血红蛋白 齿舌变色 

分 类 号：R978.1[医药卫生—药品] R969[医药卫生—药学]