利奈唑胺血药浓度与血液毒性相关性的回顾性分析

Correlation Analysis of Linezolid Concentration and Blood Toxicity

目的:基于利奈唑胺浓度检测分析对利奈唑胺血液毒性的敏感指标。方法:采用回顾性研究方法,纳入2015年4月~2018年9月在我院使用利奈唑胺抗感染治疗并监测血药浓度的住院患者,收集利奈唑胺浓度检测前后3 d的血常规指标进行比较,分析血常规指标的异常发生率,分析关键血常规指标及用药前后的差值与利奈唑胺浓度的相关性。结果:共收集107例使用利奈唑胺的患者,利奈唑胺的血药浓度范围6.01~37.38μg·ml-1;利奈唑胺血药浓度检测前后3 d,患者的红细胞计数、血红蛋白、红细胞压积、血小板计数等指标显著下降,低于正常值,且血红蛋白、红细胞计数和红细胞压积等指标的异常发生率分别为91.67%~100%,92.31%~100%,93.75%~100%。相关性分析显示,利奈唑胺血药浓度与红细胞计数和血红蛋白水平存在负相关,相关系数分别为-0.300和-0.240(P<0.05);利奈唑胺浓度与用药前后红细胞和血红蛋白差值存在正相关,相关系数分别为0.406和0.419(P<0.05)。结论:利奈唑胺治疗中,利奈唑胺血药浓度越高越容易发生红细胞和血红蛋白减少。

Objective:To investigate the abnormal indexes of blood routine test in linezolid treated patients who received the detection of linezolid concentration.Methods:A retrospective study was conducted on the patients who admitted to the First Affiliated Hospital of Wenzhou Medical University from April 2015 to September 2018.All patients were treated with linezolid and monitored the concentration of linezolid.The blood routine indexes before and after three days of linezolid concentration detection were collected and compared.The abnormal blood routine indexes were analyzed and calculated the incidence.The key abnormal indexes and the difference value before and after medication were selected to analyze the relationship with linezolid concentration.Results:A total of 107 patients were enrolled in this study,whose concentration range of linezolid was 6.01-37.38μg·ml-1.During the treatment of linezolid,three days before and after the detection of linezolid concentration,the blood routine indexes:erythrocyte,hemoglobin,hematocrit,platelet,and so on,were all lower than normal values.The abnormal incidence of hemoglobin,erythrocyte count and haematocrit(HCT)were 91.67%-100%,92.31%-100%,93.75%-100%,respectively.The correlation analysis showed that the blood concentration of linezolid was negatively correlated with erythrocyte and hemoglobin,and the correlation coefficients were-0.300 and-0.240,respectively,with statistical differences(P<0.05).There was a positive correlation between linezolid concentration and the difference value of red blood cells and hemoglobin before and after administration,with correlation coefficients of 0.406 and 0.419,respectively(P<0.05).Conclusion:In linezolid therapy,the higher the blood concentration of linezolid,the more likely reduction of erythrocyte and hemoglobin will appear.