中国药物警戒 ›› 2022, Vol. 19 ›› Issue (11): 1246-1249.
DOI: 10.19803/j.1672-8629.20210283

• 安全与合理用药 • 上一篇    下一篇

153例利奈唑胺致耐药结核病患者神经系统不良反应分析

杨少杰1, 夏玉朝1, 任鹏飞2, 王杰2, 陈裕2,*   

  1. 1郑州市第六人民医院药学部,河南 郑州 450015;
    2郑州市第六人民医院耐药结核病科,河南 郑州 450015
  • 收稿日期:2021-03-31 发布日期:2022-11-17
  • 通讯作者: *陈裕,男,本科,主任医师,结核病的诊断与治疗。E-mail：597539360@qq.com
  • 作者简介:杨少杰,男,本科,主管药师,临床药学。
  • 基金资助:
    河南省科技攻关计划项目（182102310568）

153 linezolid-associated neurologic adverse reactions in patients with drug-resistant tuberculosis: a retrospective analysis

YANG Shaojie1, XIA Yuchao1, REN Pengfei2, WANG Jie2, CHEN Yu2,*   

  1. 1Department of Pharmacy, the Sixth People’s Hospital of Zhengzhou, Zhengzhou Henan 450015, China;
    2Department of Drug-resistant Tuberculosis, the Sixth People’s Hospital of Zhengzhou, Zhengzhou Henan 450015, China
  • Received:2021-03-31 Published:2022-11-17

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摘要： 目的 分析利奈唑胺（Lzd）治疗耐药结核病（DR-TB）导致的神经系统药品不良反应（ADR）影响因素和预后。方法 对郑州市第六人民医院DR-TB患者2015年1月1日至2020年12月31日应用Lzd导致的神经系统ADR情况进行统计分析。结果 563例患者有153例（27.18%）发生神经系统ADR,其中104例（67.93%）在使用Lzd 3~9个月内发生,主要表现为周围神经炎、视神经炎及视力损伤、头痛、失眠、抑郁等,52例（33.14%）合并低蛋白血症或营养不良,28例（18.30%）合并肾功能损伤。100例（65.36%）予以停药处理。对症治疗或停用Lzd后,61例（91.04%）中枢神经系统ADR和视神经炎好转,周围神经炎预后差。结论 长期应用Lzd要密切监测神经系统ADR,尽早发现并及时处理对预后有积极影响。

关键词: 利奈唑胺, 耐药结核病, 神经系统, 药品不良反应, 周围神经炎, 视神经炎

Abstract: Objective To analyze the influencing factors and prognosis of linezolid (Lzd) associated neurologic adverse reactions in drug-resistant tuberculosis(DR-TB) patients. Methods The neurological adverse reactions caused by Lzd in DR-TB patients in the Sixth People’s Hospital of Zhengzhou between 2015 and 2020 were collected and analyzed. Results A total of 153 (27.18%) neurological adverse reactions occurred in 563 patients, 104 (67.93%) of which occurred within 3 to 9 months of use of LZD, mainly manifested as peripheral neuritis, optic neuritis, visual impairment, headache, insomnia and depression. Fifty-two cases (33.14%) were complicated with hypoproteinemia or malnutrition, and 28 (18.30%) with renal impairment. One hundred of these cases (65.36%) were discontinued with linezolid. Sixty-one cases (91.04%) of the central neurologic adverse reactions and optic neuritis were improved after symptomatic treatment or discontinuation of linezolid, but the prognosis of peripheral neuritis was poor. Conclusion Patients with long-term use of linezolid should be monitored for neurological adverse reactions. Early detection and prompt treatment have positive effects on prognosis.

Key words: linezolid, drug-resistant tuberculosis, neurologic, adverse drug reaction, peripheral neuritis, optic neuritis

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