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喹诺酮类药物是人工合成的广谱抗菌药,随着临床广泛应用,引起跟腱损伤的病例报道有所增多。引起跟腱损伤的常见药物为环丙沙星、诺氟沙星、加替沙星、依诺沙星、莫西沙星及左氧氟沙星。其机制可能与该类药物使腱细胞破坏、局部缺镁及组织坏死有关。跟腱损伤的主要临床表现为单侧或双侧跟腱疼痛和炎症性水肿,严重者可出现跟腱断裂。据报道跟腱损伤的平均发病时间为用药后6 d,平均恢复时间为停药后14 d。引起跟腱损伤的常见危险因素有糖皮质激素联用、肾功能不全、高龄、甲状腺功能亢进、使用利尿剂、周围血管病、类风湿关节炎、糖尿病及过度运动。患者一旦发生相应症状应立即停药和停止活动,并可应用糖皮质激素减轻肿胀和疼痛。喹诺酮类药物引起的跟腱损伤可导致严重后果,因此,应避免滥用喹诺酮类药物,具有危险因素者应慎用。
Quinolones are synthetic broad-spectrum antimicrobial agents, with the clinical application of a wide range of cases of Achilles tendon injuries have been reported. Common drugs that cause Achilles tendon damage are ciprofloxacin, norfloxacin, gatifloxacin, enoxacin, moxifloxacin and levofloxacin. The mechanism may be related to these drugs to tendon cell damage, local magnesium deficiency and tissue necrosis. Achilles tendon injury is the main clinical manifestations of unilateral or bilateral Achilles tendon pain and inflammatory edema, severe cases of Achilles tendon rupture may occur. It was reported that the average onset time of Achilles tendon injury was 6 days after treatment, and the average recovery time was 14 days after drug withdrawal. Common risk factors for Achilles tendon injury include glucocorticoids, renal insufficiency, advanced age, hyperthyroidism, diuretics, peripheral vascular disease, rheumatoid arthritis, diabetes and over-exercise. Patients in the event of the corresponding symptoms should be immediately stopped and stopped activities, and glucocorticoids can be applied to reduce swelling and pain. Quinolone-induced Achilles tendon damage can have serious consequences, therefore, quinolone abuse should be avoided and those with risk factors should be used with caution.