利奈唑胺致耐多药肺结核患者的不良反应及治疗措施分析

Analysis of adverse reactions of linezolid in patients with multidrug resistant tuberculosis and treatment measures

目的探讨利奈唑胺致耐多药肺结核患者的不良反应及治疗措施,为临床提供相关参考资料。方法回顾性分析120例耐多药肺结核患者的临床资料,其中利奈唑胺致不良反应患者30例,收集整理30例不良反应患者的相关资料。分析不良反应患者的性别、年龄分布情况,临床表现,不良反应发生时间,给药剂量。结果30例不良反应患者中男16例(53.33%),女14例(46.67%);18~40岁5例(16.67%),41~60岁7例(23.33%),>60岁18例(60.00%);>60岁患者占比最多。30例不良反应患者的临床表现以周围神经病变和视神经病变占比最多,分别为70.00%、13.33%。30例不良反应患者的不良反应发生时间集中于给药后2~10 d,占比为80.00%。30例不良反应患者给药剂量为600 mg/b.i.d.的占比为66.67%,大于给药剂量为300 mg/b.i.d.的33.33%。结论利奈唑胺在耐多药肺结核治疗中的不良反应较多,因此应加强利奈唑胺相关不良反应的学习,提升利奈唑胺的合理使用率,尽量减少不良反应的发生。

Objective To discuss the adverse reactions of linezolid in patients with multidrug resistant tuberculosis and treatment measures,so as to provide relevant reference data for clinical practice.Methods The clinical data of 120 patients with multidrug-resistant tuberculosis was retrospectively analyzed,among which 30 patients with adverse reactions caused by linezolid,and their relevant data was collected and counted.The gender,age distribution,clinical manifestations,time of occurrence of adverse reactions,and dosage in the patients with adverse reactions were analyzed.Results Among the 30 patients with adverse reactions,16 cases(53.33%)were male,which was more than 14 cases(46.67%)of female;5 cases(16.67%)aged 18-40 years,7 cases(23.33%)aged 41-60 years,and 18 cases(60.00%)aged>60 years,with the largest proportion of patients aged>60 years.Peripheral neuropathy and optic neuropathy accounted for the most clinical manifestations in 30 patients with adverse reactions,with 70.00%and 13.33%,respectively.The time of occurrence of adverse reactions in 30 patients with adverse reactions was concentrated between 2-10 d after drug administration,accounting for 80.00%.The percentage of 30 patients with adverse reactions administered at a dose of 600 mg/b.i.d.was 66.67%,which was greater than the 33.33%administered at a dose of 300 mg/b.i.d.Conclusion The adverse reactions of linezolid in the treatment of multidrug-resistant tuberculosis are more frequent;therefore,the study of adverse reactions related to linezolid should be enhanced,and the rational use of linezolid should be improved to minimize the occurrence of adverse reactions.