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OA

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.