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左乙拉西坦(LEV)引起的血液系统不良反应包括白细胞减少、中性粒细胞减少、血小板减少及全血细胞减少,发生率为0.01%～0.13%。LEV相关血小板减少出现或加重的时间最短为用药后3 d,最长则可达到用药后60 d,同时还可伴有血红蛋白减少,或出现全血细胞减少。不良反应严重者血小板计数可降至1×109/L以下。除实验室检查发现的血小板计数减少外,临床还可出现黏膜出血、皮肤瘀斑、血尿等症状。LEV相关血小板减少的机制尚不清楚,骨髓抑制、免疫复合物形成、非免疫性直接破坏都有可能是LEV致血小板减少的机制。临床应用LEV后应密切观察相关症状和体征,定期检查血常规。一旦出现与血小板减少相关症状应及时停药,症状较轻者停药1周后可自行恢复,较重者可输注血小板,有严重出血症状者可短期给予糖皮质激素治疗。
Levodisitan (LEV) -related hematological adverse reactions include leukopenia, neutropenia, thrombocytopenia and pancytopenia, the incidence of 0.01% to 0.13%. LEV-related thrombocytopenia or exacerbation of the shortest time after 3 d, the longest can reach 60 d after treatment, but also may be associated with decreased hemoglobin, or pancytopenia. Serious adverse reactions in patients with platelet count can be reduced to 1 × 109 / L or less. In addition to laboratory tests found that the reduction of platelet count, the clinical mucosal bleeding may occur, the skin ecchymosis, hematuria and other symptoms. The mechanism of LEV-related thrombocytopenia is unclear. Myelosuppression, immune complex formation, and non-immune direct disruption are all possible mechanisms of LEV induced thrombocytopenia. After clinical application of LEV should be closely observed the relevant symptoms and signs, regular blood tests. In the event of thrombocytopenia-related symptoms should be promptly discontinued, the less severe symptoms can be resumed after 1 week of self-recovery, heavier transfusion of platelets, severe bleeding symptoms may be short-term glucocorticoid therapy.