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目的 了解利奈唑胺(linezolid,Lzd)治疗耐多药肺结核的药物不良反应(adverse drug reaction,ADR),为临床合理用药提供参考.方法 选取广州市胸科医院肺结核科2014年10月1日至2017年3月20日使用含Lzd的化疗方案治疗耐多药肺结核的患者,共47例,对治疗过程中Lzd所致的ADR及处置结果进行分析.结果 47例患者Lzd用药中位时间为150(30～730)d,共37例(78.7％)患者发生61例次ADR.主要累及神经系统、消化系统、血液系统及皮肤,具体表现为周围神经炎24例(51.1％,24/47)、恶心15例(31.9％,15/47)、视力下降11例(23.4％,11/47)、头痛3例(6.4％,3/47),以及失眠、头晕、骨髓抑制、皮疹及瘙痒各2例(均为4.3％,2/47).用药0～6个月内发生周围神经炎(45.9％,17/37)及恶心(29.7％,11/37)的患者例数较多,用药0～8个月内发生视力下降(27.0％,10/37)的患者例数较多,8个月后上述3种ADR的新发患者例数均随用药时间的延长而逐渐降低.发生ADR的患者可采取对症(47例)、减量(11例)、暂停用药(3例)及停药(11例)等临床治疗措施,其中停药者包括周围神经炎5例、视力下降4例、骨髓抑制1例、恶心1例;37例发生ADR的患者经上述处置后最终22例(59.5％)好转,14例(37.8％)不变,1例(2.7％)加重.结论 Lzd疗程较长,发生ADR的比率较高,但只要及时处理,Lzd的使用仍是安全的.“,”Objective To investigate the adverse effects of linezolid treated MDR-TB and to provide the opinion for rational drug use.Methods Fourty seven MDR-TB patients hospitaled in the Department of Tuberculosis,Guangzhou Chest Hospital from October 1,2014 to March 20,2017 treated by regiman including linezolid were enrolled and linezolid-related adverse drug reaction (ADR) were analyzed.Results The median time of treatment of linezolid in 47 patients was 150 (30-730) d,and 37 cases (78.7％) had 61 cases of ADR,which mainly involving the nervous system,digestive system,blood system and skin.The adverse reactions associated with linezolid were shown as follows:24 cases of peripheral neuritis (51.1％,24/47),nausea in 15 cases (31.9％,15/47),decreased visual acuity in 11 cases (23.4％,11/47),3 cases of headache (6.4％,3/47),as well as insomnia,dizziness,skin rash,and bone marrow suppression were found in each 2 cases (4.3％,2/47).Most patients had peripheral neuritis (45.9％,17/37) and nausea (29.7％,11/37) within 0-6 months of medication.More patients had a decrease in visual acuity within 0-8 months (27.0％,10/37).The number of patients with peripheral neuritis,nausea and hypoacuity gradually decreased with the prolongation of the use of drug.Patients with ADR can take symptomatic treatment (47 cases),dose reduction (11 cases),suspend medication (3 cases),and drug withdrawal (11 cases).Among them,5 cases of peripheral neuritis,4 cases of visual deterioration,1 case of bone marrow suppression and 1 cases of nausea stopped taking medication in 37 patients with ADR,22 cases (59.5％)were improved,14 cases (37.8％) were not improved,1 cases (2.7％) was aggravated.Conclusion Linezolid has a higher rate of ADR during the long course of treatment.But it can be used safely when ADR was treated in time.