利奈唑胺治疗耐多药结核病患者发生神经病变的危险因素分析

doi:10.19871/j.cnki.xfcrbzz.2026.02.010

新发传染病电子杂志 ›› 2026, Vol. 11 ›› Issue (2): 51-55.doi: 10.19871/j.cnki.xfcrbzz.2026.02.010

利奈唑胺治疗耐多药结核病患者发生神经病变的危险因素分析

郑健¹, 胡秋萌², 王豪朋¹, 张培泽³, 邓国防²

1.深圳市第三人民医院药学部,广东深圳 518000;
2.深圳市第三人民医院肺病二科,广东深圳 518000;
3.深圳市第三人民医院肺病四科,广东深圳 518000

收稿日期:2025-03-03 出版日期:2026-04-30 发布日期:2026-05-18
通讯作者: 邓国防,Email:jxxk1035@yeah.net
基金资助:
1.广州国家实验室项目（GZNL2024A01030）; 2.深圳医学研究项目（C202401026）; 3.深圳市第三人民医院院级课题项目（2022098）

Risk factors for neuropathy in multidrug-resistant tuberculosis patients treated with linezolid

Zheng Jian¹, Hu Qiumeng², Wang Haopeng¹, Zhang Peize³, Deng Guofang²

1. Department of Pharmacy, Third People's Hospital of Shenzhen, Guangdong Shenzhen 518000, China;
2. The Second Department of Pulmonary Disease, Third People's Hospital of Shenzhen, Guangdong Shenzhen 518000, China;
3. The Fourth Department of Pulmonary Disease, Third People's Hospital of Shenzhen, Guangdong Shenzhen 518000, China

Received:2025-03-03 Online:2026-04-30 Published:2026-05-18

摘要/Abstract

摘要： 目的了解利奈唑胺（linezolid,LZD）治疗耐多药结核病（multidrug-resistant tuberculosis,MDR-TB）患者发生神经病变的危险因素,为临床早期识别高危人群、优化用药监测及降低神经病变发病风险提供依据。方法选取全口服短程方案治疗耐多药结核病的多中心随机撤药试验（safety and efficacy of all-oral shortened regimens for multidrug-resistant tuberculosis: a multicenter randomized withdrawal trial and a single-arm trial,SEAL-MDR）队列中于2019年5月31日至2021年12月19日在深圳市第三人民医院接受LZD治疗（600mg,每日1次,疗程6~9个月）的120例MDR-TB患者作为研究对象,将其分为发生周围神经炎和未发生周围神经炎、发生视神经炎和未发生视神经炎等组别。采用二元Logistic回归分析确定LZD治疗的MDR-TB患者发生周围神经炎、视神经炎的危险因素。结果 120例患者中,发生周围神经炎的有90例（75.00%）,未发生周围神经炎的有30例（25.00%）;发生视神经炎的有86例（71.67%）,未发生视神经炎的有34例（28.33%）。女性（OR=3.774,95%CI：1.178~12.090,P=0.025）及年龄（OR=1.034,95%CI：1.001~1.068, P=0.045）为LZD治疗的MDR-TB患者发生周围神经炎的危险因素。非本地患者（OR=2.629,95%CI：1.050~6.586,P=0.039）为LZD治疗的MDR-TB患者发生视神经炎的危险因素。结论全程使用LZD治疗的MDR-TB患者发生神经病变的风险较高。临床需重点关注高龄、女性及非本地患者,加强相关监测与干预。

关键词: 利奈唑胺, 耐多药结核病, 神经病变, 周围神经炎, 视神经炎, 危险因素

Abstract: Objective To investigate the risk factors for neuropathy in patients with multidrug-resistant tuberculosis (MDR-TB) treated with linezolid (LZD), so as to provide a basis for early clinical identification of high-risk populations, optimized medication monitoring and reduction of the risk of neuropathy. Method This study enrolled MDR-TB patients treated with linezolid (600 mg once daily for 6-9 months) at Shenzhen Third People's Hospital from May 31, 2019, to December 19, 2021 as part of the SEAL-MDR trial (safety and efficacy of all-oral shortened regimens for multidrug-resistant tuberculosis: a multicenter randomized withdrawal trial and a single-arm trial). Participants were categorized into groups based on the occurrence of peripheral neuropathy or optic neuropathy. Binary logistic regression analysis was used to identify potential risk factors for neuropathy among these patients treated with LZD. Result A total of 120 patients were enrolled in this study, among which 90 patients (75.00%) developed peripheral neuropathy, while 30(25.00%) did not. Similarly, 86 (71.67%) developed optic neuropathy, while 30(25.00%) did not. Female sex (OR=3.774, 95%CI: 1.178-12.090, P=0.025) and age (OR=1.034, 95%CI: 1.001-1.068, P=0.045) were risk factors for peripheral neuropathy in MDR-TB patients treated with LZD. Non-local patient status (OR=2.629, 95%CI: 1.050-6.586, P=0.039) was a risk factor for optic neuropathy in these patients. Conclusion MDR-TB patients treated with LZD throughout the course of therapy have a higher risk of developing neuropathy.Clinical attention should be focused on elderly patients, females, and non-local patients, with enhanced monitoring and intervention measures.

Key words: Linezolid, multidrug-resistant tuberculosis, Neuropathy, Peripheral neuropathy, Optic neuropathy, Risk factors

中图分类号:

郑健, 胡秋萌, 王豪朋, 张培泽, 邓国防. 利奈唑胺治疗耐多药结核病患者发生神经病变的危险因素分析[J]. 新发传染病电子杂志, 2026, 11(2): 51-55.

Zheng Jian, Hu Qiumeng, Wang Haopeng, Zhang Peize, Deng Guofang. Risk factors for neuropathy in multidrug-resistant tuberculosis patients treated with linezolid[J]. Electronic Journal of Emerging Infectious Diseases, 2026, 11(2): 51-55.

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利奈唑胺治疗耐多药结核病患者发生神经病变的危险因素分析

Risk factors for neuropathy in multidrug-resistant tuberculosis patients treated with linezolid

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