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中华实验和临床感染病杂志(电子版) ›› 2016, Vol. 10 ›› Issue (06) : 649 -653. doi: 10.3877/cma.j.issn.1674-1358.2016.06.001

综述

利奈唑胺治疗广泛耐药结核研究进展
张丽帆1, 边赛男2, 刘晓清3, 孙凤4, 詹思延4,()   
  1. 1. 100191 北京,北京大学公共卫生学院流行病与卫生统计学系;100730 北京,中国医学科学院北京协和医学院北京协和医院感染内科;中国医学科学院结核研究中心
    2. 100730 北京,中国医学科学院北京协和医学院北京协和医院感染内科
    3. 100730 北京,中国医学科学院北京协和医学院北京协和医院感染内科;中国医学科学院结核研究中心
    4. 100191 北京,北京大学公共卫生学院流行病与卫生统计学系
  • 收稿日期:2016-03-19 出版日期:2016-12-15
  • 通信作者: 詹思延
  • 基金资助:
    中国医学科学院北京协和医学院中央级公益性科研院所基本科研业务费(No. 2015PT320001); 艾滋病和病毒性肝炎等重大传染病防治专项项目(No. 2014ZX10003003); 国家卫生和计划生育委员会公益性行业科研专项项目(No. 201402001)

Progress of linezolid in the treatment of extensively drug-resistant tuberculosis

Lifan Zhang1, Sainan Bian2, Xiaoqing Liu3, Feng Sun4, Siyan Zhan4,()   

  1. 1. Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Department of Infectious Diseases, Peking Union Medical College Hospital; Peking Union Medical College Hospital, and Centre for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
    2. Department of Infectious Diseases, Peking Union Medical College Hospital
    3. Department of Infectious Diseases, Peking Union Medical College Hospital; Peking Union Medical College Hospital, and Centre for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
    4. Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
  • Received:2016-03-19 Published:2016-12-15
  • Corresponding author: Siyan Zhan
引用本文:

张丽帆, 边赛男, 刘晓清, 孙凤, 詹思延. 利奈唑胺治疗广泛耐药结核研究进展[J/OL]. 中华实验和临床感染病杂志(电子版), 2016, 10(06): 649-653.

Lifan Zhang, Sainan Bian, Xiaoqing Liu, Feng Sun, Siyan Zhan. Progress of linezolid in the treatment of extensively drug-resistant tuberculosis[J/OL]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2016, 10(06): 649-653.

我国是全球耐多药结核病严重流行国家之一。广泛耐药结核(XDR-TB)是最为严重的一种耐药结核病,疗效差、病死率高。利奈唑胺是噁唑烷酮类抗菌药物,研究证实其对XDR-TB治疗有效。本文通过对耐药结核的流行病学、耐药机制以及利奈唑胺的抗菌机制、治疗XDR-TB的疗效和不良反应等方面对利奈唑胺治疗XDR-TB的研究进展进行简要综述。

China is one of the high burden countries of multidrug-resistant tuberculosis (MDR-TB). Extensively drug-resistant tuberculosis (XDR-TB) is the most severe form of drug-resistant tuberculosis, characterized by poor treatment outcome and high mortality. New drug combinations for XDR-TB is a field of active research. Linezolid is a drug of anoxazolidinones with potent activity against MTB. This paper reviewed the current knowledge on linezolid for the treatment of XDR-TB, focusing on the epidemiology of drug-resistant TB, the antibiotic resistance mechanisms of M. tuberculosis, the antibiotic mechanism of linezolid and the efficacy and toxicity of linezolid in treatment of XDR-TB.

表1 利奈唑胺治疗XDR-TB的疗效和不良反应
序号 第一作者 发表时间(年) 国家 研究类型 利奈唑胺治疗MDR/XDR-TB患者(总例数) 利奈唑胺起始剂量(mg) 利奈唑胺治疗时间(月,全距) 痰菌培养转阴时间(天,全距) 治疗成功[例(%)] 不良事件[例(%)] 骨髓抑制[例(%)] 神经毒性[例(%)]
1 Park[27] 2006 韩国 前瞻性 5/8(63) 600(1例),1 200(4例) 7~18 27~147 5(100) 4(80) 4(80) 0(0)
2 Eker[28] 2008 德国 回顾性 5/74(7) 105(均值) 3(60) 1(20)
3 Condos[29] 2008 美国 前瞻性 7/7(100) 1 200(7例) 18~26 0~118a 7(100) 3(43) 2(29)
4 Anger[30] 2010 美国 回顾性 10/16(63) 1 200(8例),800(1例),600(1例) 2~29 0~118a 7(70) 10(100)
5 姚岚[31] 2010 中国 前瞻性 8/8(100) 1 200(8例) 2~11 7~210 8(100) 5(63) 3(38) 2(25)
6 Schecter[32] 2010 美国 回顾性 3/30(10) 600(3例) 13~25 224~294 2(67) 1(33) 0(0) 1(33)
7 Tangg[33] 2011 中国 前瞻性 14/14(100) 1 200(14例) 2~11 8~210 14(100) 12(86) 6(43) 3(21)
8 Koh[34] 2012 韩国 回顾性 26/51(51) 300(26例) 21(81)
9 Abbate[35] 2012 阿根廷 回顾性 17/17(100) 600(17例) 7~270 14(82) 9(53) 4(24) 3(18)
10 Lee[25] 2012 韩国 随机对照 41/41(100) 600(41例) 2~28 75(均值) 34(87)b 31(82) 7(18) 26(68)
11 Singla[36] 2012 印度 前瞻性 16/29(55) 1 200(—),600(—) 8~24 120(中位数) 15(94) 3(19) 1(6) 2(13)
12 Chang[37] 2013 中国 前瞻性 7/10(70) 800(6例),600(1例) 16~20 30~150 7(100) 4(57) 3(43) 3(43)
13 Zhang[38] 2014 中国 回顾性 15/15(100) 600(15例) 1~5 16~132 9(60) 6(40) 4(27) 1(7)
14 Liu[39] 2015 中国 回顾性 16/16(100) 600(16例) 3~21 28~91 11(69) 6(38) 3(19)
15 Tang[26] 2015 中国 随机对照 33/33(100) 1 200(33例) 0.5~24 21~147 23(70) 27(82) 17(52)c 8(24)d
16 Arbex[40] 2016 巴西 回顾性 8/12(67) 600(8例) 3.5~24 15~180 5(63) 1(13) 0(0) 1(13)
17 Yi[41] 2016 日本 回顾性 7/26(27) 1 200(—),600(—) 28(均值) 7(100) 4(57) 1(14) 0(0)
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