摘要
目的 :总结静脉滴注头孢曲松钠导致溶血性贫血的病例的发生和转归,为临床安全用药提供参考。方法:检索1995―2016年国内外科技期刊数据库,收集头孢曲松致免疫性溶血的案例报道,提取患者信息及用药后出现溶血的情况,进行统计和分析。结果:共检索到头孢曲松致免疫性溶血病例报告69例。其中44例患者年龄在10岁以下;溶血发生时间从给药后5 min至15 d不等;12例存在2次给药情况;31例患有基础疾病,其中12例为血液系统疾病;共11例死亡,其中患有血液系统疾病或者免疫缺陷的患者、并发急性肾衰竭的患者死亡率较高。结论:头孢曲松引起溶血的病例报道中10岁以下儿童病例的比例较大。临床在静脉给予头孢曲松治疗时,应对患有血液系统疾病或者免疫缺陷的患者密切关注,延长观察期,出现溶血相关症状时及时诊断。
Objective： To summarize the cases of Ceftriaxone-induced hemolytic anemia（CIHA）, and provide references for clinical application of ceftriaxone. Methods： Studies were identified through searching databases during 1995 to 2016. The inclusion criteria were case report and literature in English and Chinese. Data were extracted and analyzed including patients＇ basic information, medication and occurrence of hemolysis. Results： From a total of 69 case reports included, 44 of all the 69 patients were under 10 years old. Hemolysis occurred from 5 minutes to 15 days after the treatment; 12 cases were secondary administration ceftriaxone. Twelve cases in 31 with underlying diseases had blood system diseases. Mortality of the cases after 2000 was dramatic decline; most patients got conditional improvement by ceftriaxone withdrawal and a session of symptomatic treatment. Patients with blood system diseases, immune deficiency or complicated with acute renal failure had a higher mortality compared with whom had other complications. Conclusion： Cases of patients under 10-year old account for 64.7% of 68 case reports. Outcomes of the ADR were affected by underlying diseases, complications, timely diagnosis of CIHA. When given ceftriaxone intravenously, children, the elderly, especially those who with the blood disease are the high risk population.
出处
《临床药物治疗杂志》
2017年第7期35-39,共5页
Clinical Medication Journal
关键词
头孢曲松
溶血性贫血
不良反应
ceftriaxone
drug-induced immune anemias
adverse drug reaction（ADR）
