头孢唑肟致溶血性贫血文献分析

Literature Analysis of Ceftizoxime-induced Hemolytic Anemia

目的:探讨头孢唑肟致溶血性贫血的临床特点及相关因素,为临床安全用药提供参考。方法:检索中国知网、万方、维普、Pub Med数据库截止2017年1月31日公开发表的头孢唑肟致溶血性贫血的文献,对获得文献中患者的一般情况、临床表现、溶血发生时间、转归及发生机制等相关因素进行统计分析。结果:共检索到相关文献17篇,病例21例;其中男16例(76.19%),年龄分布以60岁以上年龄段最多(9例,42.86%);溶血反应多发生在用药后的7 d内(18例,85.71%);贫血纠正的平均时间为7.5 d,血红蛋白值与贫血恢复时间呈负相关。3例(14.29%)患者救治无效死亡。发生机制主要为免疫复合物和药物吸附。结论:临床医师和药师应了解头孢唑肟导致溶血性贫血的发生规律,正确选择用药人群,加强用药监护及用药教育,尽早识别严重不良反应并及时处理。

Objective：To investigate the characteristics and correlated factors of cefiizoxime-induced hemolytic a- nemia, and provide reference for clinical safe use of ceftizoxime. Methods： Literatures of hemolytic anemia induced by ceft- izoxime published until January 2017 were retrieved from CNKI, Wanfang database, VIP database and PubMed, and ana- lyzed statistically in respects of general informations, clinical manifestation, accurcence time, outcome and mechanism. Results： A total of 17 literatures including 21 cases were obtained. There were 16 male patients （76.19%） ; patients with age I〉60 years had the highest percentage （9 cases, 42.86% ）. Hemolytic reaction mostly occurred within 7 days after medication （ 18 cases, 85.71% ）. The mean time of anemia correction was 7.5 days, and hemoglobin was negatively corre- lated with the recovery time of anemia. Three patients（ 14.29% ） died. The mechanisms of hemolytic anemia were mainly the production of immune complex and drug adsorption. Conclusion： Clinicians and pharmacists should understand the characteristics of hemolytic anemia caused by ceftizoxime, choose the right population, strengthen the pharmaceutical care and patient education in order to early detection and timely management of serious adverse reactions.