利奈唑胺致新生儿与老年患者血小板减少分析

Clinical analysis on the thrombocytopenia associated with linezolid therapy in neonates and elderly patients

目的:探讨新生儿和老年患者使用利奈唑胺致血小板减少的变化规律及相关危险因素。方法:回顾性分析某院2009年4月-2012年4月应用利奈唑胺致血小板减少症的新生儿和老年患者临床资料。结果:新生儿的血小板减少症发生率显著低于老年组(17.95%vs 37.76%,P<0.01),并且其血小板开始降至底限及最低值的时间比老年组更短(P<0.001)。血小板减少症的危险因素有严重感染、联用其他抗菌药物、基础血小板值低,另外老年患者存在高龄、肝肾功能不全等,而新生儿存在早产儿低体重儿、围产期窒息及高胆红素血症等因素。结论:掌握利奈唑胺致血小板减少的特点将有助于该药的安全使用。

OBJECTIVE To discuss the variation and related factors of thrombocytopenia caused by linezolid in neonates and elderly patients.METHODS This was a retrospective analysis of the clinical data of neonates and elderly patients with thrombocytopenia who were treated with linezolid between April 2009 and April 2012.RESULTS The incidence of thrombocytopenia was much lower in neonates than elderly patients（17.95% vs 37.76%,P0.01）,The time of platelet count in neonates began to limit and the minimum value shorter than that in the elderly patients.Serious infections,combination with other antimicrobial agents and low level of baseline platelet count were as the risk factors for thrombocytopenia.Other factors as advanced age,liver and renal insufficiency were still existed in elderly patients,and preterm infants,low birth weight,perinatal asphyxia and hyperbilirubinemia in neonates.CONCLUSION To grasp the characteristics of thrombocytopenia induced by linezolid will contribute to the safe use of the drug.