利奈唑胺治疗腹腔感染1例报告

1 病历资料 患者男,39岁,因"反复发作上腹痛6年,加重5 d"于2007-11-29入院.患者自述2001-2007年"胆囊炎"和"急性胰腺炎"多次发作,均经内科治疗后好转.5 d前因劳累及饮酒后再发腹痛,在外院查血尿淀粉酶增高,经内科治疗不能缓解,逐渐出现腹压增高、血压下降、少尿症状,遂在外院急诊行"胰腺松解术,胃、空肠、胆囊造瘘术".     

利奈唑胺治疗ICU重症感染27例

目的探讨利奈唑胺在ICU重症感染患者中应用的有效性及安全性。方法对入住ICU的27例重症感染患者给予利奈唑胺0.6 g,2次/d,观察用药前和用药72 h后的体温、血常规、肝肾功能等指标的变化并进行对比分析,以评价药物的有效性及安全性。结果 27例患者中19例好转,8例死亡或自动出院,临床有效率为70.37%。使用利奈唑胺72 h后,患者体温血象均较前下降,血小板计数稍有下降,肝肾功能无明显变化,所观察的指标治疗前后差异无统计学意义(P0.05)。结论利奈唑胺在重症感染患者中短期应用是安全有效的,长期应用的药物副作用需要进一步观察。     

利奈唑胺治疗儿童白血病化疗后重症感染12例效果观察

目的观察利奈唑胺治疗儿童白血病化疗后重症感染的临床疗效及安全性。方法对12例儿童白血病化疗后重症感染者予利奈唑胺静注,10 mg/kg,每8 h1次,疗程8～18 d。观察致病菌清除率,临床疗效及不良反应。结果致病菌清除率为100%;痊愈8例、显效3例、进步0例、无效1例,总有效率为92%;不良反应均较轻微,停药后自行恢复。结论利奈唑胺治疗儿童白血病化疗后重症感染疗效较好,且较为安全。     

利奈唑胺治疗老年肺部感染的临床疗效分析

目前耐甲氧西林金黄色葡萄球菌(MRSA)检出率有逐年升高的趋势,其对β-内酰胺类、氟喹诺酮类等多种抗生素大多耐药,临床多首选万古霉素,但近年来又出现了对万古霉素中介或耐药的金葡菌,对革兰阳性菌感染的治疗提出了新的挑战[1].利奈唑胺作为第一个应用于临床的新型恶唑烷酮类抗菌药,其在体内外对各类革兰阳性球菌具有高度抗菌活性,且由于其作用靶点和作用方式的独特,故其在临床应用上越来越受到关注.本文对在我院住院治疗的老年肺部感染患者应用利奈唑胺的疗效及其安全性进行总结分析.     

利奈唑胺对肺部革兰氏阳性细菌感染患者肾功能的影响

利奈唑胺是新型的恶唑烷酮类抗菌药,对革兰氏阳性细菌有很强的抗菌作用,与其它抗菌药无交叉耐药性。我们观察了利奈唑胺对患者肾功能的影响,并与万古霉素进行比较。     

利奈唑胺致老年肺部感染患者血小板减少1例报告

1 病例资料 患者女,86岁,因发现肾功能异常10余年,纳差、乏力 3 d 于2009年5月22 日入院.入院诊断:(1)慢性肾功能不全,肾功能衰竭期;(2)高血压 3 级(极高危);(3)2 型糖尿病;(4)冠心病;(5)脑梗死.患者于6月4日出现精神萎靡、寒战、发热,体温最高达 38.6 ℃,伴咳嗽,咯淡黄色黏痰.查体:咽无红肿,双侧扁桃体不大.两肺呼吸音稍粗,右下肺闻及少量湿性啰音.查血常规提示白细胞 (WBC) 13.9×109/L,中性粒细胞 (N) 0.885,红细胞 (RBC) 2.73×1012/L,血红蛋白 (HB) 88 g/L,血小板 (PLT) 150×109/L.     

利奈唑胺治疗老年重症肺炎的疗效和安全性评价

目的 对比观察利奈唑胺治疗老年重症耐甲氧西林金黄色葡萄球菌( MRSA)的有效性及安全性.方法回顾性分析我院2009年1月至2010年12月收治的老年重症MRSA肺炎患者50例,分为利奈唑胺治疗组和万古霉素治疗组,比较两组患者的临床治疗总有效率、细菌清除率及不良反应发生率等指标.结果 利奈唑胺组与万古霉素组临床总有效率分别为75.0％、46.2％,差异有统计学意义(P＜0.05);细菌清除率分别为70.8％、53.8％,差异无统计学意义(P＞0.05);不良反应发生率分别为16.7％、46.2％,差异有统计学意义(P＜0.05).结论 利奈唑胺组治疗老年重症MRSA肺炎临床疗效优于万古霉素组,对老年重症MRSA肺炎患者安全、有效.     

利奈唑胺不良反应文献分析

目的探讨利奈唑胺不良反应发生的一般规律及特点,为临床医师、临床药师合理用药提供科学依据。方法检索2000～2012年中国知网《CHKD期刊全文数据库》和《万方数据知识服务平台》内收录的50例利奈唑胺不良反应患者的文献资料并进行统计分析。结果利奈唑胺所致不良反应常在用药第1周（46.43%）、第2周（30.36%）发生;50例患者中70岁以上高龄患者占66%;不良反应多为对血液系统的影响（86%）,主要表现为血小板减少（76%）,64.10%血小板减少患者血小板低至50×109/L以下,最低值4×109/L,其他表现为全血细胞减少、贫血、粒细胞减少、白细胞减少,再次为血乳酸水平升高、血压升高等。结论临床医师、药师应重视利奈唑胺所致的严重不良反应,注意加强用药监护,确保用药安全、有效。     

利奈唑胺在革兰阳性耐药菌感染中的应用研究

伴随抗生素的广泛应用,细菌耐药情况日趋加重.革兰阳性耐药菌,如耐甲氧西林金葡菌(MRSA)、耐万古霉素肠球菌(VRE)和耐青霉素肺炎链球菌(PRSP)感染等,已成为社会和院内感染中的重要致病菌.大量文献报道显示,新型恶唑烷酮类抗生素——利奈唑胺,对革兰阳性耐药菌有良好抗菌活性.现就利奈唑胺及其在革兰阳性耐药菌感染中的应用做一综述,以对指导临床用药提供一定帮助.     

Systemic lupus erythematosus with refractory hemolytic anemia effectively treated with cyclosporin A: a case report

A 51 year old woman with systemic lupus erythematosus (SLE) serially developed thrombocytopenia, arthritis, lupus nephritis, pleuritis, mesenteric vasculitis and refractory hemolytic anemia during the past 19 years prior to presentation. The woman had been managed with high doses of prednisolone, splenectomy, methylprednisolone pulse therapy and cytotoxic drugs, including oral cyclophosphamide, azathioprine, mexotrexate and monthly parenteral cyclophosphamide for hemolytic anemia. After two months of therapeutic trial with Cyclosporin A (CsA) (3 mg/kg), the follow-up hemoglobin (Hb) level was increased to 12.0 gm% and the dose ofprednislone was reduced to 5 mg every other day without occurring rebound during the subsequent three months. There were no obvious side effects from the medication.     

痰塔特姆菌致呼吸道感染1例报告

痰塔特姆菌是罕见的条件致病菌。作者从1例呼吸道感染患者痰液标本中培养分离出呈优势生长的痰塔特姆菌。根据药敏结果予以抗感染治疗,患者痰病原菌培养转阴,病情好转出院。     

A case report of refractory warm autoimmune hemolytic anemia treated with plasmapheresis and rituximab

A 30-year-old male presented with severe, warm autoimmune hemolysis 17 months subsequent to a matched, unrelated peripheral hematopoietic stem cell transplant. The patient responded poorly to conventional therapy with steroids and immunoglobulin, prompting the initiation of rituximab. On account of persistent, severe hemolysis, therapeutic plasma exchange was employed as a bridge until the rituximab therapy became effective. Immediately following plasmapheresis, the patient demonstrated clinical improvement followed by attenuation of the hemolysis and improved reticulocytosis. The hemoglobin concentration and reticulocyte index demonstrated further improvement following subsequent doses of rituximab and continued following the cessation of plasmapheresis. This case suggests the utility of plasmapheresis and rituximab in severe, life-threatening cases of warm autoimmune hemolytic anemia refractory to conventional therapy.     

A case of refractory polyarteritis nodosa successfully treated with rituximab

A 59-year-old man who presented with continuous fever, livedo reticularis, and left leg ischemia with multiple tibial artery stenosis and renal artery aneurysm, as demonstrated by arteriography, was diagnosed with polyarteritis nodosa (PAN) 6 years ago. Although he frequently relapsed in spite of intensive immunosuppressive therapies, the disease activity of PAN was controlled with repeated rituximab (RTX) therapies and steroid doses were tapered safely. Peripheral CD19⁺ B-cells disappeared soon after the 1st administration of RTX. Although CD19⁺ B-cells remained absent, 3.1% of CD3⁺CD20⁺ T-cells were observed in the peripheral blood prior to the 2nd administration of RTX. Recent studies have suggested the pathogenic role of CD3⁺CD20⁺ T-cells in autoimmune diseases in the context of RTX therapy; therefore, their roles in the pathogenesis of PAN also need to be considered.     

Acute cytomegalovirus infection associated with pulmonary embolism treated successfully with rivaroxaban: case report

Journal of Thrombosis and Thrombolysis - Severe life-threatening thromboembolism may be caused exclusively by the presence of an acute CMV infection or due to the association of this agent and...