利奈唑胺对肺炎患者血小板生成能力及血小板调控因子水平的影响

Effect of Linezolid on platelet production in pneumonia patients

摘要:

目的??观察重症肺炎患者接受利奈唑胺治疗后血小板生成能力及血浆中血小板调控因子水平的变 化。方法??选取 2016 年 10 月—2017 年 10 月中国人民解放军联勤保障部队第九〇一医院收治的成年重症肺 炎患者 32 例。给予利奈唑胺治疗，在用药前 1 天、用药第 3 天及停药后第 3 天分别采集血浆标本，采用酶联 免疫吸附试验（ELISA）检测血浆白细胞介素 -3（IL-3） 、白细胞介素 -11（IL-11） 、血小板生成素（TPO） 等促血小板生成因子的水平，测定血小板计数、阳性网织血小板比例及平均血小板体积等指标反映患者血小 板生成能力。结果??接受利奈唑胺治疗后患者未出现明显的血小板计数减少及肝肾功损伤等严重不良反应。 与用药前 1 天比较，用药第 3 天患者血浆 IL-3、IL-11 及 TPO 等促血小板生成因子水平降低（ P <0.05） ，阳 性网织血小板比例降低（ P <0.05） 。停药后第 3 天患者血浆中 IL-3、 IL-11、 TPO 及阳性网织血小板比例回升， 与用药前 1 天水平比较差异无统计学意义（ P >0.05） 。结论??利奈唑胺可降低血浆 TPO 在内的多种促血小板 生成因子水平， 抑制骨髓血小板生成能力。停药后利奈唑胺介导的血小板抑制效果可迅速地恢复。

Abstract:

Objective To investigate the impacts of Linezolid platelet production in G + pneumonia patients. Methods From October 2016 to October 2017, 32 adult patients with G + pneumonia received treatment of Linezolid. The serum levels of interleukin (IL)-3, IL-11 and thrombopoietin (TPO) were measured by enzyme linked immunosorbent assay (ELISA) 1 day before treatment, the 3rd day during the treatment, and at the 3rd day post treatment of Linezolid. The platelet counts (Plt), reticulocyte platelet (RP) ratios and mean platelet volumes (MPV) were also recorded at these time-points. Results No patients suffered from thrombocytopenia or severe liver/ kidney dysfunction. Serum levels of IL-3, IL-11, TPO and the RP ratios significantly decreased at the 3rd day during Linezolid treatment compared with those 1 day before the treatment (P < 0.05). At the 3rd day after the treatment, the serum levels of platelet regulatory cytokines and the RP ratios were recovered back to the basal level compared with those 1 day before the treatment (P > 0.05). Conclusions Linezolid treatment inhibits the capabilities of platelet production probably via decreasing the serum levels of platelet regulatory cytokines such as IL-3, IL-11 and TPO, which can rapidly recover after stopping Linezolid treatment.