在MDR-TB患者中停止使用线索利德后视觉恢复:详细的病例分析
Yovil Bagas Wiyana1, Isnin Anang Marhana1, Gatot Suhartono2
1Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Case reports in pulmonology
|August 4, 2025
概括
线索利德是治疗多耐药结核病 (MDR-TB) 的抗生素,可引起视神经病变,导致视力丧失. 终止线索利德治疗允许逐渐改善视力,突出显示需要监测眼部毒性.
科学领域:
- 眼科医生 眼科 眼科
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 耐多药结核病 (MDR-TB) 需要复杂的治疗方案.
- 莱涅佐利德是MDR-TB的关键抗生素,但具有眼睛毒性的风险.
- 视神经病变是已知的linezolid的副作用,通常表现为视力丧失.
研究的目的:
- 在患有MDR-TB的患者中报告linezolid诱导的视神经病变病例.
- 为了强调眼科监测在长时间的linezolid治疗期间的重要性.
- 突出药物戒断后可逆视力丧失的可能性.
主要方法:
- 一个47岁的男性患者的案例研究,患有复发性MDR-TB.
- 治疗方案包括levofloxacin,linezolid,clofazimine和cycloserine. 这三种药物是最常见的.
- 进行了眼科检查,包括OCT和MRI. 由于视力障碍,莱涅佐利德的治疗已停止.
主要成果:
- 患者在线索利德治疗9个月后出现了渐进的视力障碍.
- 眼科评估证实光神经病变没有内病理.
- 尽管最初接受了类固醇治疗,但在停止使用linezolid后,视力逐渐得到改善.
结论:
- 在患有MDR-TB的患者中,莱涅佐利德可以引起可逆性视神经病变.
- 定期的眼科评估对于长期服用linezolid的患者至关重要.
- 及时停止使用线索利德可以防止永久性视力损伤.
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