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替加环素(tigecycline)是一种新型广谱抗生素,为甘氨酰环素类(glycyclines)抗生素的首个药物,其化学结构与四环素相似。替加环素对革兰阳性菌和革兰阴性菌具有抗菌活性,用于治疗复杂皮肤、软组织感染和复杂腹腔内感染。通常,替加环素偶致急性胰腺炎,但近年资料表明,替加环素致急性胰腺炎有所增加。临床表现主要为恶心、呕吐、腹痛、腹胀以及血清脂肪酶和淀粉酶水平升高。替加环素致胰腺炎的机制尚不明确,但由于替加环素的结构与四环素结构相似,推测替加环素是通过四环素致胰腺炎的同样机制引起急性胰腺炎。替加环素若引起胰腺炎,应立即停药,保持患者禁食状态,静脉给予足量液体,并给予其他对症治疗。替加环素使用期间,临床医师应密切观察患者有无胰腺炎的症状和体征,监测患者的血清脂肪酶和淀粉酶水平。
Tigecycline is a new broad-spectrum antibiotic, the first drug for glycyclines antibiotics and has a chemical structure similar to tetracycline. Tigecycline has antibacterial activity against gram-positive and gram-negative bacteria and is used to treat complex skin, soft tissue infections and complex intra-abdominal infections. In general, tigecycline causes acute pancreatitis, but in recent years the data show that tigecycline-induced acute pancreatitis has increased. The main clinical manifestations of nausea, vomiting, abdominal pain, abdominal distension and serum lipase and amylase levels. The mechanism of tigecycline-induced pancreatitis is not clear, but because of the similar structure of tigecycline and tetracycline, it is speculated that tigecycline causes acute pancreatitis by the same mechanism of tetracycline-induced pancreatitis. Tigecycline if caused by pancreatitis, should be discontinued immediately to keep the patient fasting, adequate intravenous fluid, and give other symptomatic treatment. During the use of tigecycline, clinicians should closely observe the patient’s presence or absence of pancreatitis symptoms and signs and monitor the patient’s serum lipase and amylase levels.