[關(guān)鍵詞]
[摘要]
目的 探討抗菌藥物致血小板減少發(fā)生的規(guī)律和特點,為臨床安全用藥提供參考。方法 檢索2000年1月-2016年12月中國學(xué)術(shù)期刊(光盤版)、萬方數(shù)字化期刊全文庫、中文科技期刊全文數(shù)據(jù)庫(維普)等數(shù)據(jù)庫報道的抗菌藥物引起血小板減少的個案病例文獻,并對其進行分析和討論。結(jié)果 青霉素類、頭孢類、唑烷酮類、抗結(jié)核藥和氟喹諾酮類藥物發(fā)生較多,一般發(fā)生在用藥后2周內(nèi)(83.33%);臨床表現(xiàn)上有僅血小板減少(38.89%)、血小板減少并皮膚瘀斑瘀點(37.30%)、血小板減少并口鼻出血(18.25%);在處理方法上43.65%患者僅給予了停藥或換用其他藥物處理,55.56%患者血小板計數(shù)在7 d內(nèi)恢復(fù)。結(jié)論 臨床中應(yīng)警惕抗菌藥物導(dǎo)致血小板減少的發(fā)生,一旦發(fā)生應(yīng)首選停藥等措施進行處理,多數(shù)患者能在短時間內(nèi)恢復(fù),嚴重患者可給予糖皮質(zhì)激素、人免疫球蛋白、輸注血小板等治療。
[Key word]
[Abstract]
Objective To investigate the rules and characteristics of thrombocytopenia caused by antibiotics, and to provide the references for the safe use of drugs in clinic. Methods Chinese Academic Journal (CD), Wangfang Database, Chinese Science and Technology Journal Full-text Database (VIP) were retrieved from January 2000 to January 2016, and the documents of thrombocytopenia caused by antibiotics were analyzed and discussed. Results Cases of thrombocytopenia caused by penicillins, cephalosporins, oxazolidinone, anti-tuberculosis drugs, and fluoroquinolones were more than others, which generally occurred during 2 weeks after treatment (83.33%). Clinical manifestations included thrombocytopenia (38.89%), thrombocytopenia and skin petechia (37.30%), thrombocytopenia and oronasal hemorrhage (18.25%). Patients (43.65%) were treated with drug withdrawal or changing to other drugs. Blood platelet count of patients (55.56%) was recovered in 7 d. Conclusion Attentions should be paid to thrombocytopenia caused by antibiotics, which should be firstly treated by withdrawing drugs, and most patients will recover within a short time. Serious cases may be treated with glucocorticoids, human immunoglobulin, and platelet transfusion therapy.
[中圖分類號]
[基金項目]