利奈唑胺注射液致血小板减少的回顾性分析

目的:调查我院住院患者使用利奈唑胺注射液后发生血小板减少的病例,为促进利奈唑胺合理用药提供依据。方法:采用回顾性研究方法,调取我院2017年1~6月使用利奈唑胺注射液患者的病例资料,统计患者基本信息、用药情况及用药期间血小板变化,依据相关标准确定利奈唑胺相关血小板减少病例,并对患者的性别、年龄、感染部位、用药时间、合并抗菌药物和用药前后Plt数值变化等因素进行分析。结果:研究共纳入167例静脉滴注正常剂量利奈唑胺的患者,其中20例发生血小板减少症,发生率为11.98%。关联性评价结果:很可能2例(10.00%),可能18例(90.00%)。女性血小板减少发生率高于男性;青年和老年患者血小板减少发生率较高,其中青年患者(18~40岁)最高;肝脏部位感染患者血小板减少发生率最高;血小板减少发生率随用药时间的增加而显著提高;合并使用抗菌药物越多,血小板减少发生率越高;以及基线Plt<200.0×10^9·L^-1可能是血小板减少的危险因素。结论:利奈唑胺相关性血小板减少症是该药较常见不良反应,临床使用时应关注女性、青年和老年、肝脏部位感染、用药周期长、基线Plt<200.0×10^9·L^-1的高发人群,尽可能减少联合使用抗菌药物品种数,用药前后密切监测患者血常规,以减少严重不良事件的发生,保障患者用药安全。

Retrospective Analysis of Thrombocytopenia Induced by Linezolid Injection

Objective: To investigate the incidence of thrombocytopenia induced by linezolid injection in our hospital, providing evidence for rational use of linezolid. Methods:Retrospective study method was used, the patient cases in our hospital using linezolid injection were gathered from January 2017 to June 2017. The basic information, drug use and platelet changes of patients were analyzed. And the related cases of thrombocytopenia after using linezolid injection were identified according to relevant criteria. The gender, age, infection site, medication duration, combined antibacterials, and platelet changes of patients were analyzed. Results:167 patients with intravenous linezolid were included in the study, thrombocytopenia occurred in 20 patients. The incidence rate was 11.98%. The relevance evaluation results of adverse reaction were as follows: adverse reactions were very likely to be related to linezolid in 2 cases(10.00%), adverse reactions might be related to linezolid in 18 cases(90.00%). The incidence of thrombocytopenia was higher in women than in men. The incidence of thrombocytopenia was higher in young and elderly patients, of which young patients(18-40 years old) had the highest incidence. Patients with liver infection had the highest incidence of thrombocytopenia. The incidence of thrombocytopenia significantly increased with the duration of medication and the number of combined antibacterials. And the baseline Plt<200.0×10^9·L^-1 might be a risk factor for thrombocytopenia. Conclusion:The thrombocytopenia induced by linezolid was common. Therefore, more attention should be paid to the high-risk populations with women, young adults and the elderly, liver infection, long-term use of medication and the baseline Plt<200.0×10^9·L^-1 in clinical practice. At the same time, the number of antibacterials should be reduced. The blood routine of patients should be monitored during the using of linezolid for ensuring medication safety, and reducing the occurrence of serious adverse events.