利福平联合艾多沙班治疗肺结核合并深静脉血栓形成1例报道

doi:10.19871/j.cnki.xfcrbzz.2023.06.013

摘要/Abstract

摘要： 肺结核是严重危害人类健康的传染病,肺结核患者发生静脉血栓栓塞症（venous thromboembolism,VTE）的风险高,抗凝药物是治疗VTE的重要措施。然而,利福平作为抗结核治疗中的关键药物,与较多的抗凝药物存在药物相互作用,因此,探讨肺结核患者使用利福平时抗凝药物的选择非常重要。本文报道了1例69岁女性肺结核患者,入院后超声提示双下肢胫后静脉、肌间静脉血栓,予以华法林抗凝治疗后,国际标准化比值极不稳定,停用华法林更换为艾多沙班,治疗3个月后复查提示下肢静脉血栓消失,肺部病灶明显吸收好转。本例患者的治疗情况及药物相互作用的数据显示,对于需要同时应用利福平和抗凝药物的患者,使用艾多沙班更为安全有效,保障抗结核方案完整的同时抗凝治疗有效,亦可使肺结核患者获得较好的早期疗效。

关键词: 利福平, 肺结核, 深静脉血栓, 华法林, 艾多沙班

Abstract: Tuberculosis (TB) is a major infectious disease that seriously jeopardizes human health, and TB patients are at high risk of venous thromboembolism (VTE). Anticoagulant drugs are an important measure for treating VTE. However, Rifampicin, as an important drug in anti-tuberculosis treatment, has drug-drug interactions with a larger number of anticoagulant drugs, so it is important to explore the option of anticoagulant regimen when Rifampicin is used in TB patients. In this paper, a 69-year-old female TB patient was reported, who was admitted to the hospital with ultrasound suggesting thrombosis of the posterior tibial veins and intermuscular veins of both lower limbs, and was treated with Warfarin for anticoagulation, which resulted in an extremely unstable international normalized ratio. Then, Warfarin was discontinued and replaced with Edoxaban, and a review after 3 months of treatment suggested that VTE of the lower limbs disappeared, and the lung lesions were obviously absorbed and improved. In this case, the treatment results and DDI data showed that the use of Edoxaban is safer and more effective for patients who need to take a combination of Rifampicin and anticoagulant drugs, which ensures the completeness of the anti-tuberculosis regimen and the effectiveness of anticoagulation therapy, and also enables a better early therapeutic effect in TB patients.

Key words: Rifampin, Pulmonary tuberculosis, Deep vein thrombosis, Warfarin, Edoxaban

中图分类号:

R521.5

罗廷茹, 孙楠楠. 利福平联合艾多沙班治疗肺结核合并深静脉血栓形成1例报道[J]. 新发传染病电子杂志, 2023, 8(6): 69-72.

Luo Tingru, Sun Nannan. A case report of a combination of Rifampicin and Edoxaban in the treatment of TB complicated by deep vein thrombosis[J]. Electronic Journal of Emerging Infectious Diseases, 2023, 8(6): 69-72.

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