中国药物警戒 ›› 2022, Vol. 19 ›› Issue (8): 904-907.
DOI: 10.19803/j.1672-8629.2022.08.18

• 安全与合理用药 • 上一篇    下一篇

利奈唑胺致重症感染患儿血小板减少回顾性分析

王亚杰1, 王晓玲2, 钱素云2, 杨梅2*   

  1. 1洛阳市妇幼保健院,河南 洛阳 471023;
    2国家儿童医学中心,首都医科大学附属北京儿童医院,北京 100045
  • 收稿日期:2020-09-24 出版日期:2022-08-15 发布日期:2022-08-15
  • 通讯作者: *杨梅,女,硕士,主任药师,临床药学。E-mail：yangmei910@163.com
  • 作者简介:王亚杰,女,硕士,主管药师,临床药学。
  • 基金资助:
    北京市医院管理中心临床医学发展专项（ZYLX-201813）

Linezolid-associated thrombocytopenia in children with severe infection: a retrospective analysis

WANG Yajie1, WANG Xiaoling2, QIAN Suyun2, YANG Mei2*   

  1. 1Luoyang Maternal and Child Health Hospital, Luoyang Henan 471023, China;
    2Children’s National Medical Center, Beijing Children’s Hospital Affiliated to Capital Medical University, Beijing 100045, China
  • Received:2020-09-24 Online:2022-08-15 Published:2022-08-15

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摘要： 目的 分析利奈唑胺治疗重症感染患儿对血小板的影响。方法 对2018年10月1日至2019年7月31日在北京儿童医院儿童重症医学科住院患儿使用利奈唑胺进行抗感染治疗的临床资料进行回顾性分析。结果 纳入研究24例患儿,中位年龄为5.01（四分位距：1.75~9.07）岁;其中6例血小板减少（2例输注血小板对症处理,4例自行恢复正常）,发生率为25.0%;血小板减少的中位时间为4.00（四分位距：3.25~5.50）d,血小板恢复正常的中位时间为5.00（四分位距：3.25~6.75）d。结论 重症感染患儿使用利奈唑胺出现相关血小板减少的危险因素有血小板基线值偏低、利奈唑胺谷浓度较高、脏器功能损害等。建议根据利奈唑胺血药浓度进行个体化剂量调整。

关键词: 利奈唑胺, 儿童重症医学科, 血小板减少, 药品不良反应

Abstract: Objective To investigate the effect of linezolid (LZD) on platelets of children with severe infections. Methods The clinical data on patients hospitalized in the Department of Pediatric Intensive Care Unit (PICU) due to severe infections and treated with linezolid between October 1, 2018 and July 31, 2019 was retrospectively analyzed. Results The median age of the 24 patients enrolled in this study was 5.01 (interquartile range, IQR, 1.75~9.07) years old, six of whom developed linezolid-associated thrombocytopenia (LAT) (2 children received symptomatic treatment with platelet transfusion, and 4 children returned to normal spontaneously) and the incidence of LAT was 25.0%. The median time to onset of LAT and median time to resolution of thrombocytopenia from onset were 4 (IQR, 3.25~5.50) days and 5 (IQR, 3.25~6.75) days, respectively. Conclusion Risk factors for linezolid-associated thrombocytopenia among children with severe infections include low baseline platelet count, high Cmin of linezolid and impairment of visceral function. It is suggested that the dose of LZD should be adjusted individually according to its serum concentration.

Key words: linezolid, pediatric intensive care unit, thrombocytopenia, adverse drug reactions

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