中国药物警戒 ›› 2025, Vol. 22 ›› Issue (7): 794-798.
DOI: 10.19803/j.1672-8629.20240988

• 安全与合理用药 • 上一篇    下一篇

48例哌拉西林钠他唑巴坦钠血液系统不良反应分析

陈耀哲1, 詹云丽2, 宋兴栋1, 朱漫玉2, 欧雪媚3, 李楚云1,*   

  1. 1惠州市中心人民医院药学部,广东 惠州 516001;
    2惠州市药品不良反应监测中心,广东 惠州 516001;
    3惠州市中心人民医院胸心外科,广东 惠州 516001
  • 收稿日期:2024-12-16 出版日期:2025-07-15 发布日期:2025-07-17
  • 通讯作者: *李楚云,女,学士,主任药师,临床药学与药物警戒。E-mail: chuyunweiwei@163.com.com
  • 作者简介:陈耀哲,男,硕士,主管药师,临床药学与药品不良反应监测。
  • 基金资助:
    惠州市科技计划项目（2022CZ010118）

48 Cases of Hematological Adverse Reactions Associated with Piperacillin Sodium and Tazobactam Sodium

CHEN Yaozhe1, ZHAN Yunli2, SONG Xingdong1, ZHU Manyu2, OU Xuemei3, LI Chuyun1,*   

  1. 1Department of Pharmacy, Huizhou Central People’s Hospital, Huizhou Guangdong 516001, China;
    2Huizhou Adverse Drug Reaction Monitoring Center, Huizhou Guangdong 516001, China;
    3Department of Thoracic and Cardiac Surgery, Huizhou Central People’s Hospital, Huizhou Guangdong 516001, China
  • Received:2024-12-16 Online:2025-07-15 Published:2025-07-17

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摘要： 目的 探讨哌拉西林钠他唑巴坦钠血液系统药品不良反应（ADR）,为合理用药提供参考。方法 回顾性分析本院2019年1月1日至2023年12月31日上报的哌拉西林钠他唑巴坦钠血液系统ADR报告。结果 48例哌拉西林钠他唑巴坦钠血液系统ADR报告中,男性36例,女性12例,平均年龄（59.67±18.74）岁;血液系统ADR主要表现为血小板减少（22例次）、白细胞减少（17例次）,平均血小板减少数（43.05±18.57）×109·L-1、白细胞减少数（1.71±0.83）×109·L-1,发生ADR时间分别为（5.59±3.74）d、（21.14±6.04）d,差异具有统计学意义（P<0.001）;也可出现白细胞+血小板或白细胞+血小板+血红蛋白同时减少,白细胞增多,血小板增多,血红蛋白下降。临床表现多为无症状,个别出现发热,经对症治疗后,46例好转,2例死亡。ADR严重程度主要为Ⅲ级（25例）;白细胞减少患者中有5例再次使用哌拉西林钠他唑巴坦钠,1例再次出现白细胞减少。结论 哌拉西林钠他唑巴坦钠血液系统ADR主要表现为白细胞减少、血小板减少,临床表现常无症状或仅为发热,及时停用及对症治疗,预后较好。

关键词: 哌拉西林钠他唑巴坦钠, 血液系统不良反应, 白细胞减少, 血小板减少, 药品不良反应

Abstract: Objective To investigate the adverse drug reactions (ADR) of piperacillin sodium and tazobactam sodium in the hematological system in order to provide a reference for rational medications. Methods Reports about hematological ADR caused by piperacillin sodium and tazobactam sodium submitted by a hospital in 2019-2023 were analyzed. Results Forty-eight related reports were collected, involving 36 males and 12 females with a mean age of (59.67±18.74) years. The hematological ADR were primarily manifested as thrombocytopenia (22 cases) and leukopenia (17 cases). The mean platelet count was (43.05±18.57)×109·L-1 for thrombocytopenia while the mean count of white blood cells was (1.71±0.83)×109·L-1 for leukopenia. The time to onset of ADR was (5.59±3.74) days and (21.14±6.04) days, respectively, with statistically significant differences (P<0.001). The symptoms included simultaneous reductions in white blood cells and platelets or in white blood cells, platelets and hemoglobin, and leukocytosis, thrombocytosis, and decreased hemoglobin levels. Clinically, most of the patients were asymptomatic, but a few had a fever. Following symptomatic treatment, 46 cases improved while 2 cases died. These ADR were mostly classified as grade III (25 cases). Among the patients with leukopenia, five were reexposed to piperacillin sodium and tazobactam sodium, and leukopenia recurred in one case. Conclusion The primary manifestations of hematological ADR induced by piperacillin sodium and tazobactam sodium include leukopenia and thrombocytopenia, which are clinically often asymptomatic or may present only with fever. Prompt discontinuation of medication and symptomatic treatment can lead to a favorable prognosis.

Key words: Piperacillin Sodium and Tazobactam Sodium, Hematologic Adverse Reactions, Leukopenia, Thrombocytopenia, Adverse Drug Reactions

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