我院老年患者使用利奈唑胺的不良反应分析

摘要

OBJECTIVE:To analyze the safety of linezolid (LZD) for elderly patients,and probe into the regularity of adverse reaction (ADR).METHODS:In retrospective study,elderly patients treated with LZD injection or tablets were selected from our hospital during Jan.2014-Dec.2015.The occurrence of ADRs were analyzed statistically.RESULTS:A total of 126 patients were included,the age was from 65 to 94 year-old,and the mean duration of treatment was (9.47 ± 6.31) d (ranged 1-35 d).Forty-five cases suffered from ADR after medication (35.71％),followed by 39 cases of thrombocytopenia (30.95％),9 cases of leukocytopenia(7.14 ％),7 cases of hemoglobin reduction (5.55 ％),6 cases of nausea and vomiting (4.76 ％),4 cases of transaminase elevation (3.17％),4 cases of diarrhea (3.17％),2 cases of lactic acidosis (1.59％),2 cases of skin rash (1.59％) and 1 case of drug fever (0.79％).The incidence of thrombocytopenia in ICU patients was significantly higher than non-ICU patients,with statistical significance (P=0.019).There was no significant difference among different dosage forms of LZD without statistical significance (P=0.218).CONCLUSIONS:Clinicians and pharmacists should closely monitor the application of LZD in elderly patients,pay more attention to ADR induced by LZD,especially in ICU,it induces the high incidence of thrombocytopenia.Meanwhile,it is suggested to monitor serum lactate concentrations regularly during treatment.%目的:对老年住院患者使用利奈唑胺的安全性进行分析,并探讨其不良反应发生规律.方法:采用回顾性研究方法,选取我院2014年1月-2015年12月使用利奈唑胺注射剂或片剂的老年患者病例,统计并分析不良反应发生情况.结果:共纳入有效病例126例,年龄65～94岁,使用利奈唑胺的平均时间为(9.47±6.31)d(范围1～35 d).用药后出现不良反应的有45例(35.71％),其中血小板减少39例(30.95％),白细胞减少9例(7.14％),血红蛋白减少7例(5.55％),恶心、呕吐6例(4.76％),转氨酶升高4例(3.17％),腹泻4例(3.17％),乳酸性酸中毒2例(1.59％),皮疹2例(1.59％),药物热1例(0.79％).重症监护治疗病房(ICU)患者血小板减少症的发生率明显高于非ICU患者,差异有统计学意义(P=0.019);利奈唑胺不同剂型间的发生率比较,差异无统计学意义(P=0.218).结论:医师和临床药师应该对使用利奈唑胺的老年患者密切监护,警惕不良反应的发生,尤其是ICU患者,其血小板减少发生率较高,且应常规监测血清乳酸水平.