利奈唑胺治疗重症耐多药肺结核临床观察及不良反应分析

新发传染病电子杂志 ›› 2019, Vol. 4 ›› Issue (4): 217-219.

利奈唑胺治疗重症耐多药肺结核临床观察及不良反应分析

季乐财, 余卫业, 谭卫国, 吕德良, 吕建文

深圳市慢性病防治中心, 广东深圳 518020

出版日期:2019-12-30 发布日期:2020-07-21
通讯作者: 余卫业, Email：ywy2002@126.com

Clinical observation and adverse reactions analysis of linezolid in the treatment of severe multi-drug resistant pulmonary tuberculosis

JI Le-cai, YU Wei-ye, TAN Wei-guo, LV De-liang, LV Jian-wen

Shenzhen Center For Chronic Disease Control, Guangdong Shenzhen 518020, China

Online:2019-12-30 Published:2020-07-21

摘要/Abstract

摘要： 目的探讨利奈唑胺在治疗重症耐多药结核病, 特别是广泛耐药结核病前期(pre-XDR-TB)和广泛耐药结核病（XDR-TB）中的作用。方法收集2015年7月1日至2017年6月30日深圳市慢性病防治中心结核病门诊确诊为pre-XDR-TB患者9例, XDR-TB患者3例, 总结人口学特征及疾病特征, 经科室专家会诊后制定含利奈唑胺的个体化治疗方案, 治疗过程中根据药敏结果及不良反应调整治疗方案, 观察临床疗效及药物不良反应。结果12例患者中10例治愈, 2例失败, 治疗成功率83.3%（10/12）。12例患者中8例出现需处理的不良反应, 其中视神经损伤3例, 停用利奈唑胺经眼科处理后视力恢复。1例出现轻度贫血, 3例出现白细胞减少, 经对症治疗后恢复正常。7例出现肝功损害, 其中5例需短时间停药并修订治疗方案, 之后顺利完成治疗。结论利奈唑胺是治疗重症耐多药结核病的重要组成药物, 疗效理想, 副作用可控, 值得推广。

关键词: 利奈唑胺, 耐多药肺结核, pre-XDR-TB, XDR-TB, 药物不良反应

Abstract: Objective To investigate the role of linezolid in the treatment of severe multidrug-resistant tuberculosis, especially the pre-XDR-TB and XDR-TB. Methods 9 patients with pre-XDR-TB and 3 patients with XDR-TB were collected from the tuberculosis clinic of Shenzhen Center for Chronic Disease Control from July 1, 2015 to June 30, 2017. The demographic characteristics and disease characteristics were summarized. After consultation with specialists in the departments, the individualized treatment plan containing linezolid was formulated. During the treatment, the treatment plan was adjusted according to the Results of drug sensitivity and adverse reactions, and the clinical efficacy and drugs adverse reactions were observed. Results 10 were cured and 2 failed. The success rate of treatment was 83.3% (10/12). 8 of the 12 patients had adverse reactions, including 3 cases of optic nerve injury. The visual acuity was restored after discontinuation of linezolid. One case had mild anemia and 3 cases had leukopenia, which returned to normal after symptomatic treatment. There were 7 cases of liver function damage, of which 5 cases needed to stop medication for a short time and change the treatment plan, and then completed the treatment smoothly. Conclusion Linezolid is effective in the treatment of severe MDR-TB, with controlled side effects and it is worth promotion.

Key words: Linezolid, Multidrug-resistant tuberculosis, pre-XDR-TB, XDR-TB, Drugs adverse reaction

季乐财, 余卫业, 谭卫国, 吕德良, 吕建文. 利奈唑胺治疗重症耐多药肺结核临床观察及不良反应分析[J]. 新发传染病电子杂志, 2019, 4(4): 217-219.

JI Le-cai, YU Wei-ye, TAN Wei-guo, LV De-liang, LV Jian-wen. Clinical observation and adverse reactions analysis of linezolid in the treatment of severe multi-drug resistant pulmonary tuberculosis[J]. Electronic Journal of Emerging Infectious Diseases, 2019, 4(4): 217-219.

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