文献报道的9例利奈唑胺相关性低血糖不良反应分析

Analysis of 9 Cases of Adverse Reactions of Linezolid Associated Hypoglycemia Reported in the Literature

目的:分析利奈唑胺相关性低血糖的发生特点,为临床合理用药提供参考。方法:检索WanFang Data、VIP、CNKI及PubMed等国内外文献数据库,筛选利奈唑胺相关性低血糖病例报道的相关文献,提取患者的国籍、性别、年龄、原发病、基础疾病、用药剂量、给药途径、出现时间、临床表现、处理及转归等信息进行统计分析。结果:共筛选出有效病例报道9篇,9例患者;美国5例,中国3例,印度1例;男5例,女4例;低血糖多出现在使用利奈唑胺后1周以上(7例,77.78%)。5例糖尿病病例最低血糖值0.2~3.1 mmol·L^(-1),3例非糖尿病病例血糖最低血糖值0.9~1.06 mmol·L^(-1)。单纯低血糖3例,合并≥2种其他不良反应6例。诊断后均停用利奈唑胺,静脉予葡萄糖等对症治疗,存活患者低血糖大多在24 h内纠正。3例死亡,6例存活。结论:利奈唑胺相关性低血糖多发生在高龄、合并有基础疾病、高累积剂量或长疗程用药患者。早诊断、及时停药,对症治疗,多数患者预后较好。

Objective:To analyze the characteristics of linezolid associated hypoglycemia and provide a reference for rational drug use. Methods:The case reports of linezolid associated hypoglycemia were collected from WanFang Data, VIP, CNKI, PubMed from April 1, 2000 to June 30, 2021. After screening, data from included literature were extracted and analyzed, including patients’ nationality, gender, age, original disease, basic disease, dosage, route of administration, occurrence time, clinical manifestations, clinical treatment and outcome. Results:A total of 9 valid case reports were screened, including 9 patients, 5 from the Unite States, 3 from China, 1 from India;5 were males and 4 were females;Hypoglycemia mostly occurred more than 1 week after the use of linezolid(7 cases, 77.78%). The minimum blood glucose of 5 diabetes mellitus were 0.2-3.1 mmol·L^(-1) with diabetes, and 0.9-1.06 mmol·L^(-1) of 3 non-diabetes mellitus. There were 3 cases of simple hypoglycemia and 6 cases of combined greater than or equal to 2 kinds of other adverse reactions. Linezolid was discontinued after the diagnosis of hypoglycemia, and take symptomatic treatment such as intravenous glucose, surviving patients hypoglycemia were normal within 24 hours. 3 were died, 6 were alive. Conclusion:Linezolid induced hypoglycemia mostly occurs in elderly, with underlying diseases, high cumulative dose or long-term treatment. Early diagnosis and timely discontinuation of the drug might be helpful to a better prognosis in general.