一例利奈唑胺用于治疗 MDR 结核性脑膜炎致血小板降低的病例分析

  • 何 松 重庆市璧山区人民医院
  • 戴 文真 重庆市璧山区人民医院
关键词: 治疗;结核性脑膜炎;血小板;病例分析

摘要

利奈唑胺为噁唑烷酮类抗菌药物,通过抑制蛋白质合成的早期阶段,而起到杀菌作用,临床上主要用于治疗耐甲 氧西林金黄色葡萄球菌引起的医院获得性肺部感染、复杂性皮肤和皮肤软组织感染、菌血症以及耐万古霉素的肠球菌感染 [1]。 利奈唑胺有良好的组织穿透能力,脑脊液浓度 / 血药浓度约有 60%-70% 左右,临床研究表明 [2],利奈唑胺用于 MRSA 的中枢 神经系统疗效好,多项回顾性临床研究 [3-4] 均观察到利奈唑胺联合其他抗结核药物治疗耐药结核杆菌感染能取得良好疗效。2016 年、2020 年 WHO 结核耐药指南将利奈唑胺纳入一线治疗方案 [5-6]。但利奈唑胺的不良反应发生率较高,尤其是骨髓抑制(白细 胞、血小板减少等)可达 32.93%[7]。本文通过一例使用利奈唑胺治疗多重耐药结核性脑膜炎,引起血小板减少的病例分析,探讨 MDR 结核性脑膜炎的治疗,为临床提供一些参考。

参考

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2024-01-05
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