摘要
左乙拉西坦(LEV)引起的血液系统不良反应包括白细胞减少、中性粒细胞减少、血小板减少及全血细胞减少,发生率为0.01%～0.13%。LEV相关血小板减少出现或加重的时间最短为用药后3 d,最长则可达到用药后60 d,同时还可伴有血红蛋白减少,或出现全血细胞减少。不良反应严重者血小板计数可降至1×109/L以下。除实验室检查发现的血小板计数减少外,临床还可出现黏膜出血、皮肤瘀斑、血尿等症状。LEV相关血小板减少的机制尚不清楚,骨髓抑制、免疫复合物形成、非免疫性直接破坏都有可能是LEV致血小板减少的机制。临床应用LEV后应密切观察相关症状和体征,定期检查血常规。一旦出现与血小板减少相关症状应及时停药,症状较轻者停药1周后可自行恢复,较重者可输注血小板,有严重出血症状者可短期给予糖皮质激素治疗。
Levetiracetam （LEV）-induced hematological adverse reactions include leukopenia, neutropenia, thrombocytopenia, and pancytopenia; and the incidence was 0. 01% -0.13% . The shortest time to LEV-associated thrombocytopenia onset or aggravation is 3 days after drug administration and the longest time could reach to 60 days after drug use. Meanwhile, hypochromia or pancytopenia may occur. The platelet count could decrease to 〈 1 × 109/L in the serious patient. Besides the reduction of platelet count showed by laboratory test, mucosal bleeding, skin petechia, hematuria, and other symptoms may also develop. Although the mechanism of LEV- associated thrombocytopenia is unclear, marrow suppression, immune complex formation, and direct harm by nonimmune factors are thought to be related to it. Attention should be paid to the patients with symptoms and signs related to thrombocytopenia after LEV use and routine blood tests should be regularly performed. LEV should be withdrawn immediately if thrombocytopenia-related symptoms occur. Patient with more mild symptoms can recover spontaneously one week after drug discontinuation and patient with more severe symptoms should be treated with platelet transfusion. Patients with severe hemorrhagic symptoms could be treated with short-term glucocorticoid.
出处
《药物不良反应杂志》
2012年第2期98-100,共3页
Adverse Drug Reactions Journal
