利奈唑胺治疗耐药肺结核致重度贫血3例分析并文献复习

Analysis about 3 cases of linezolid-induced severe anemia and literature review

目的 通过病例分析及文献复习探讨利奈唑胺的血液系统不良反应。方法 收集、分析首都医科大学附属北京胸科医院2015年6月至2016年1月收治的3例应用利奈唑胺治疗耐药结核病出现重度贫血患者的临床资料并文献复习。结果 3例患者应用利奈唑胺治疗4~12个月出现重度贫血,停药后1.5~6个月血红蛋白恢复正常。文献提示利奈唑胺引起贫血的原因与骨髓抑制有关;联合应用利奈唑胺和维生素B6可减轻利奈唑胺的血液系统不良反应;治疗中需要监测血液系统不良反应,必要时进行血涂片及骨髓穿刺检查。结论 利奈唑胺可导致重度贫血,停药后可恢复。

Objective: In order to cause clinicians’concern about hematological side effect of linezolid by cases analysis and literature review. Method Collected and analysed clinical data of 3 cases of severe anemia treatmed with linezolid-containing regimens, and reviewed literatures relative to linezolid. Result 3 patients got severe anemia after using linezolid-containing regimens 4-12months, the hemoglobins(Hb) returned to normal after discontinuing linezolid 1.5-6months. Combination treatment of linezolid and vitamin B6 might alleviate linezolid?associated hematologic side effect. Side effect about hematological system relative to linezolid should be surveyed, blood smear and bone marrow examination should be implemented when necessary. Conclusion Linezolid may cause severe anemia, Hb can return to normal after discontinue lizenolid reatment.