利奈唑胺对肺炎患者血小板生成能力及血小板调控因子水平的影响

Effect of Linezolid on platelet production in pneumonia patients

目的观察重症肺炎患者接受利奈唑胺治疗后血小板生成能力及血浆中血小板调控因子水平的变化。方法选取2016年10月—2017年10月中国人民解放军联勤保障部队第九〇一医院收治的成年重症肺炎患者32例。给予利奈唑胺治疗,在用药前1天、用药第3天及停药后第3天分别采集血浆标本,采用酶联免疫吸附试验(ELISA)检测血浆白细胞介素-3(IL-3)、白细胞介素-11(IL-11)、血小板生成素(TPO)等促血小板生成因子的水平,测定血小板计数、阳性网织血小板比例及平均血小板体积等指标反映患者血小板生成能力。结果接受利奈唑胺治疗后患者未出现明显的血小板计数减少及肝肾功损伤等严重不良反应。与用药前1天比较,用药第3天患者血浆IL-3、IL-11及TPO等促血小板生成因子水平降低(P <0.05),阳性网织血小板比例降低(P <0.05)。停药后第3天患者血浆中IL-3、IL-11、TPO及阳性网织血小板比例回升,与用药前1天水平比较差异无统计学意义(P>0.05)。结论利奈唑胺可降低血浆TPO在内的多种促血小板生成因子水平,抑制骨髓血小板生成能力。停药后利奈唑胺介导的血小板抑制效果可迅速地恢复。

Objective To investigate the impacts of Linezolid platelet production in G+ pneumonia patients.Methods From October 2016 to October 2017,32 adult patients with G+ pneumonia received treatment of Linezolid.The serum levels of interleukin(IL)-3,IL-11 and thrombopoietin(TPO)were measured by enzyme linked immunosorbent assay(ELISA)1 day before treatment,the 3rd day during the treatment,and at the 3rd day post treatment of Linezolid.The platelet counts(Plt),reticulocyte platelet(RP)ratios and mean platelet volumes(MPV)were also recorded at these time-points.Results No patients suffered from thrombocytopenia or severe liver/ kidney dysfunction.Serum levels of IL-3,IL-11,TPO and the RP ratios significantly decreased at the 3rd day during Linezolid treatment compared with those 1 day before the treatment(P<0.05).At the 3rd day after the treatment,the serum levels of platelet regulatory cytokines and the RP ratios were recovered back to the basal level compared with those 1 day before the treatment(P>0.05).Conclusions Linezolid treatment inhibits the capabilities of platelet production probably via decreasing the serum levels of platelet regulatory cytokines such as IL-3,IL-11 and TPO,which can rapidly recover after stopping Linezolid treatment.