1例利奈唑胺致血小板减少症病例的原因分析

Reason Analysis on 1 Case with Thrombocytopenia Induced by Linezolid

目的:分析利奈唑胺致血小板减少症的不良反应病例发生原因及其处理意见。方法:对收治的1例临床考虑为自发性腹膜炎患者,采用利奈唑胺抗感染治疗后致患者血小板计数呈进行性下降趋势,分析其利奈唑胺致不良反应的原因与相关性。结果:血小板计数下降与利奈唑胺血药浓度间无相关性,停用利奈唑胺改用替考拉宁继续抗感染治疗后,血小板计数逐渐回升;当其升至81×10^(9)/L时再次使用利奈唑胺治疗,原有的血小板计数再次进行性降至28×10^(9)/L,改用替考拉宁继续抗感染治疗7 d后血小板升至61×10^(9)/L。结论:血小板下降的原因与利奈唑胺之间存在相关性,故认为血小板下降是由利奈唑胺所致,临床在使用利奈唑胺抗感染用药时应引起高度重视。

Objective:To analyze the reasons and treatment of adverse drug reactions of thrombocytopenia induced by linezolid.Methods:For one case of spontaneous peritonitis,the platelet count showed a progressive decline after the antiinfective treatment with linezolid.The reasons and correlation of the adverse drug reactions caused by linezolid were analyzed.Results:There was no correlation between the decrease of platelet count and the blood concentration of linezolid.After the discontinuation of linezolid and the replacement of teicoplanin with anti-infective medication,the platelet count gradually increased.When it was increased to 81×10^(9)/L,linezolid was used again,and the original platelet count was progressively reduced to 28×10^(9)/L again.The platelet count was increased to 61×10^(9)/L 7 days after the replacement of teicoplanin with anti-infection medication.Conclusion:There is a correlation between the reason of thrombocytopenia and linezolid,so it is believed that the cause of thrombocytopenia is caused by linezolid,which should be paid more attention when using linezolid anti-infective medication in clinic.