地榆升白片预防和治疗耐多药结核病患者利奈唑胺致白细胞减少的临床观察  

Clinical observation of Diyu Shengbai tablets in prevention and treatment of leukopenia caused by linezolid in patients with multidrug-resistant tuberculosis

作　　者：蒋怀龙 胡卫华 李宏宇 张晓磊 李琦剑 韩珊 金龙 JIANG Huailong;HU Weihua;LI Hongyu;ZHANG Xiaolei;LI Qijian;HAN Shan;JIN Long(Internal Medicine Department Eight,Infectious Disease Hospital of Heilongjiang Province,Harbin 150500,China;不详)

机构地区：[1]黑龙江省传染病防治院内八科,黑龙江哈尔滨150500 [2]黑龙江省传染病防治院感染科,黑龙江哈尔滨150500 [3]黑龙江省传染病防治院检验科,黑龙江哈尔滨150500 [4]黑龙江省传染病防治院科教科,黑龙江哈尔滨150500

出　　处：《山东医药》2025年第3期12-16,共5页Shandong Medical Journal

基　　金：黑龙江省卫生健康委科研项目(20210303110315)。

摘　　要：目的观察地榆升白片预防和治疗耐多药结核病(MDR-TB)患者利奈唑胺致白细胞减少的临床效果。方法选择拟采用利奈唑胺治疗的MDR-TB患者66例,按照随机数字表法分为治疗组31例、对照组35例。两组均给予含利奈唑胺的抗结核方案进行治疗,治疗组在此基础上口服地榆升白片,每次0.4 g,3次/天,共3个月。对照组利奈唑胺治疗2个月内发生白细胞减少者,参照治疗组口服地榆升白片,每次0.4 g,3次/天,共1个月。记录两组治疗1、2、3个月白细胞减少及中性粒细胞减少的发生情况。比较对照组利奈唑胺治疗2个月内发生白细胞减少者地榆升白片治疗前及治疗1个月后的白细胞计数及中性粒细胞计数,评价其疗效后计算总有效率。治疗组及对照组未使用地榆升白片者抗结核治疗3个月期间监测肝肾功能,记录肝肾功能异常情况。结果治疗组治疗1、2、3个月均无白细胞减少发生,对照组治疗1、2、3个月分别发生白细胞减少3、4、2例,白细胞减少总发生率为25.7%;治疗组治疗3个月白细胞减少总发生率低于对照组(P<0.05)。治疗组治疗1、2、3个月均无中性粒细胞减少发生,对照组治疗1、2、3个月分别发生中性粒细胞减少2、4、2例,中性粒细胞减少总发生率为22.9%;治疗组治疗3个月中性粒细胞减少总发生率低于对照组(P<0.05)。利奈唑胺治疗2个月内对照组7例白细胞减少者地榆升白片治疗前后白细胞计数分别为(2.90±0.93)×10^(9)/L、(4.47±1.46)×10^(9)/L,中性粒细胞计数分别为(1.45±0.54)×10^(9)/L、(2.64±1.27)×10^(9)/L;与治疗前比较,对照组白细胞减少者治疗后白细胞计数、中性粒细胞计数均升高(P均<0.05)。对照组白细胞减少者地榆升白片治疗后显效5例、有效1例、无效1例,总有效率为85.71%。两组治疗期间肝功能异常发生率比较差异无统计学意义(P>0.05),治疗组治疗期间肾功能异常发生率低于对照组未�Objective To observe the clinical effects of Diyu Shengbai tablets in the prevention and treatment of leukopenia caused by linezolid in patients with multidrug-resistant tuberculosis(MDR-TB).Methods Sixty-six patients with MDR-TB to be treated with linezolid were selected and randomly divided into the treatment group of 31 cases and control group of 35 cases.Patients in both groups were treated with an anti-tuberculosis regimen containing linezolid;in the treatment group,patients were orally administered Diyu Shengbai tablets,0.4 g each time,3 times each day for 3 months.For those who developed leukopenia within 2 months of linezolid treatment in the control group,they were instructed to orally take Diyu Shengbai tablets,0.4 g each time,3 times each day for 1 month.The occurrence of leukopenia and neutropenia at 1,2 and 3 months of treatment was recorded in both groups.We compared the white blood cell counts and neutrophil counts of leukopenic patients who developed leukopenia in the control group within 2 months of linezolid treatment with Diyu Shengbai tablets before treatment and after 1 month of treatment,and then calculated the overall effective rate after evaluating their therapeutic efficacy.Liver and kidney functions were monitored during 3 months of anti-tuberculosis treatment in the treatment group and the control group without Diyu Shengbai tablets,and abnormalities of liver and kidney functions were recorded.Results No leukopenia occurred in the treatment group at 1,2,and 3 months of treatment,and 3,4,and 2 cases of leukopenia occurred in the control group at 1,2,and 3 months of treatment,respectively,with an overall incidence of leukopenia of 25.7%(9/35);the overall incidence of leukopenia at 3 months of treatment was lower in the treatment group than in the control group(P<0.05).No neutropenia occurred in the treatment group at 1,2,and 3 months of treatment,and 2,4,and 2 cases of neutropenia occurred in the control group at 1,2,and 3 months of treatment,respectively,with an overall incidence of neut

关 键 词：地榆升白片 利奈唑胺 耐多药结核病 骨髓抑制 白细胞减少 中性粒细胞减少 

分 类 号：R521[医药卫生—内科学]