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1例68岁女性患者,因感染性心内膜炎口服利奈唑胺0.6 g,2次/d,半个月后感觉疲乏、倦怠,血常规检查示白细胞4.18×109/L,红细胞3.23×1012/L,血红蛋白76 g/L,血小板40×109/L,遂停药。11 d后血象恢复正常,再次口服利奈唑胺0.6 g,2次/d,用药14 d复查血常规,白细胞3.50×109/L,红细胞2.51×1012/L,血红蛋白71 g/L,血小板36×109/L,遂再次停药。停药后患者连续5 d发热(体温最高时38.5℃),伴咳嗽、咯黄痰及鼻塞,遂入院。入院后未给予抗感染药物,先后3次输注浓缩红细胞(每次400 ml)。血常规示:白细胞5.90×109/L,红细胞3.33×1012/L,血红蛋白95 g/L,血小板158×109/L,故在入院第21天给予利奈唑胺0.6 g静脉注射,2次/d。入院第36天复查血常规,白细胞2.30×109/L,红细胞2.21×1012/L,血红蛋白61 g/L,血小板29×109/L,遂再次停用利奈唑胺。先后3次输注悬浮红细胞(每次400 ml),皮下注射重组人粒细胞集落刺激因子150μg,1次/d,共4 d。应患者要求准予出院。
A 68-year-old woman with infective endocarditis received oral nicardipine 0.6 g twice daily for half a month and experienced fatigue and fatigue. A blood test showed leukocyte 4.18 × 109 / L and erythrocyte 3.23 × 1012 / L, hemoglobin 76 g / L, platelet 40 × 109 / L, then discontinued. Blood was returned to normal after 11 days. Linezolid 0.6 g twice daily for 14 days. Blood samples were taken for 14 days. The white blood cell count was 3.50 × 109 / L, erythrocyte 2.51 × 1012 / L, hemoglobin 71 g / L, platelet 36 × 109 / L, then discontinue again. After stopping the patient for 5 days fever (the highest temperature 38.5 ℃), with cough, slightly yellow sputum and stuffy nose, then hospitalized. Admission was not given after anti-infective drugs, infusion of concentrated red blood cells 3 times (400 ml each). Blood routine showed: white blood cells 5.90 × 109 / L, erythrocytes 3.33 × 1012 / L, hemoglobin 95 g / L, 158 × 109 / L platelet, so on the 21st day of linezolid given 0.6 g intravenously, 2 times / d . On the 36th day after admission, blood routine examination was performed. The white blood cells were 2.30 × 109 / L, the erythrocytes were 2.21 × 1012 / L, the hemoglobin was 61 g / L, the platelets were 29 × 109 / L, and the linezolid was again disabled. Three consecutive infusions of suspended erythrocytes (400 ml each) were injected subcutaneously with recombinant human granulocyte colony-stimulating factor 150 μg once daily for 4 days. Patients should be allowed to discharge.