利奈唑胺对高龄男性耐甲氧西林金黄色葡萄球菌患者血液生理指标影响及安全性分析

Effect of linezolid on routine blood indices and its safety in very old males with meticillin-resistant Staphylococcus aureus infection

目的：观察利奈唑胺对耐甲氧西林金黄色葡萄球菌（MRSA）感染的高龄男性患者血液生理指标及安全性的影响。方法选取2012年4月至2013年3月在解放军总医院住院并确诊MRSA感染的46例高龄男性患者（83～95岁），均给予利奈唑胺注射液治疗，0.6g、1次/12h，疗程10～14d。比较治疗前后红细胞（RBC）、血红蛋白（HB）、白细胞（WBC）、血小板（PLT）和网织红细胞（Ret）等血液生理指标变化。观察治疗期间出血不良反应。结果治疗后与治疗前比较，HB[（95.609±14.210） vs （102.478±15.941）g/L]、WBC＆#215;1012/L [（6.944±2.590） vs （8.728±2.277）]、Ret[（1.124%±0.844%） vs （1.789%±0.831%）]和PLT＆#215;109/L [（142.913±62.065） vs （227.304±56.250）]均显著降低，差异均有统计学意义（P＜0.01）。治疗期间共有22例患者发生出血倾向，出现2个部位出血患者10例（22%），3个部位出血患者4例（9%），≥4个部位出血患者2例。结论利奈唑胺能降低高龄男性患者HB、PLT、Ret水平，治疗期间需警惕出血并发症。

Objective To determine the effects of linezolid on the routine blood indices and investigate the safety in the very old male patients with meticillin-resistant Staphylococcus aureus （MRSA） infection. Methods A total of 46 male patients （aged 83-95 years） with confirmed MRSA infection in Chinese PLA General Hospital from April 2012 to March 2013 were enrolled in this study. They were all treated with intravenous injection of 0.6g linezolid, once every 12h, for 10 to 14d. Their routine blood indices such as red blood cell （RBC）, hemoglobin （HB）, white blood cell （WBC）, platelet （PLT） and reticulocyte （Ret） were compared before and after the treatment. The hemorrhage events were recorded during the treatment. Results After treatment with linezolid, the level of HB [（95.609±14.210） vs （102.478±15.941）g/L], count of WBC[×1012/L, （6.944±2.590） vs （8.728±2.277）], Ret [（1.124%±0.844%） vs （1.789%±0.831%）] and PLT[×109/L, （142.913±62.065） vs （227.304±56.250）] were significantly decreased compared with before treatment （P〈0.01）. Bleeding events occurred in 22 patients. Among them, 10 patients （22%） had 2 bleeding sites, 4 patients （9%） had 3 bleeding sites, 2 patients had ≥4 bleeding sites. Conclusion Linezolid decreases the serum levels of PLT, HB and Ret in very old male patients with MRSA. So a special attention should be paid to bleeding during the treatment.