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目的:探讨头孢唑肟致溶血性贫血的临床特点及相关因素,为临床安全用药提供参考。方法:检索中国知网、万方、维普、Pub Med数据库截止2017年1月31日公开发表的头孢唑肟致溶血性贫血的文献,对获得文献中患者的一般情况、临床表现、溶血发生时间、转归及发生机制等相关因素进行统计分析。结果:共检索到相关文献17篇,病例21例;其中男16例(76.19%),年龄分布以60岁以上年龄段最多(9例,42.86%);溶血反应多发生在用药后的7 d内(18例,85.71%);贫血纠正的平均时间为7.5 d,血红蛋白值与贫血恢复时间呈负相关。3例(14.29%)患者救治无效死亡。发生机制主要为免疫复合物和药物吸附。结论:临床医师和药师应了解头孢唑肟导致溶血性贫血的发生规律,正确选择用药人群,加强用药监护及用药教育,尽早识别严重不良反应并及时处理。
Objective: To investigate the clinical characteristics and related factors of ceftizoxime-induced hemolytic anemia and provide reference for clinical safety. METHODS: The literature of ceftizoxime-induced hemolytic anemia published on CNKI, Wanfang, VIP, Pub Med database as of January 31, 2017 was searched. The general situation, clinical manifestation, time of hemolysis , Outcome and mechanism and other related factors for statistical analysis. Results: A total of 17 articles were retrieved and 21 cases were found. There were 16 males (76.19%) with the age distribution over the age of 60 (9 cases, 42.86%). Hemolytic reactions occurred mostly on the 7th day (18 cases, 85.71%). The mean time to correct anemia was 7.5 days. The hemoglobin value was negatively correlated with the recovery time of anemia. Three patients (14.29%) died of treatment ineffective. The mechanism is mainly immune complexes and drug adsorption. Conclusion: Clinicians and pharmacists should be aware of the occurrence of hemolytic anemia caused by ceftizoxime, choose the correct medication group, strengthen the monitoring of drug use and medication education, identify serious adverse reactions as soon as possible and timely treatment.