<link rel="stylesheet" href="https://studioyszimg.yxj.org.cn/css/video-js.min.css?v=1"><link rel="stylesheet" href="https://studioyszimg.yxj.org.cn/article/css/base.css?v=5"><link rel="stylesheet" href="https://studioyszimg.yxj.org.cn/article/css/index.css?v=35"><link rel="stylesheet" href="https://ysz-web.yxj.org.cn/live/dist/static/base/index.css?ysz_v=2.0"><script src="https://studioyszimg.yxj.org.cn/js/dsbridge.js?v=13" type="text/javascript"></script><script src="https://ysz-web.yxj.org.cn/dsBridge/main.js?v=26" type="text/javascript"></script><script src="https://ysz-web.yxj.org.cn/live/dist/static/base/fun.js?ysz_v=3" type="text/javascript"></script><script src="https://ysz-web.yxj.org.cn/live/dist/static/js/nativeToWeb.js?v=1" type="text/javascript"></script><div id="ysz-header" style="margin:0;overflow:hidden;"><h1 style="font-size:24px;line-height:1.8;color:#333333;word-wrap:break-word;">甲硝唑、替硝唑、奥硝唑，绝不是差一个字那么简单</h1><h2 style="font-size:16px;color:#999999;word-wrap:break-word;"><em style="font-style:normal;margin-right:10px;color:#7f7f7f;display:inline-block;">2020-12-22</em><em style="font-style:normal;margin-right:10px;color:#7f7f7f;display:inline-block;">原创：医学界医生站整理编辑</em></h2></div><p>硝基咪唑类药物是化学合成的抗菌药，是使用比较广泛的一类药物，包括第一代的&nbsp;甲硝唑&nbsp;、第二代的&nbsp;替硝唑&nbsp;、第三代的&nbsp;奥硝唑&nbsp;和第四代的&nbsp;塞克硝唑&nbsp;。</p><p><br/></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span style="font-size: 16px;">尽管名称有些相似，但其性质还是有些差异的。今天我们就来说说前三代的差异。</span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><br/></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span class="ysz-ueditor-title-one" style="font-size: 18px; line-height: 28px; font-weight: bold; color: rgb(215, 0, 15); text-align: left;">药理不同</span><br/></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span class="ysz-ueditor-title-one" style="font-size: 18px; line-height: 28px; font-weight: bold; color: rgb(215, 0, 15); text-align: left;"><br/></span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><img src="https://studioyszimg.yxj.org.cn/2020122215355300230.png" title="" alt=""/></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><br/></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span class="ysz-ueditor-title-one" style="font-size: 18px; line-height: 28px; font-weight: bold; color: rgb(215, 0, 15); text-align: left;">用法不同</span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><br/></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><img src="https://studioyszimg.yxj.org.cn/2020062914424400016.png" title="" alt="" style="padding: 0px; margin: 0px auto; border-style: none; width: auto;"/></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><br/></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span class="ysz-ueditor-title-one" style="font-size: 18px; line-height: 28px; font-weight: bold; color: rgb(215, 0, 15); text-align: left;">不良反应不同</span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><br/></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><img src="https://studioyszimg.yxj.org.cn/2020062914433300017.png" title="" alt="" style="padding: 0px; margin: 0px auto; border-style: none; width: auto;"/></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><br/></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span class="ysz-ueditor-title-one" style="font-size: 18px; line-height: 28px; font-weight: bold; color: rgb(215, 0, 15); text-align: left;">特殊人群使用不同</span><br/></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><br/></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><img src="https://studioyszimg.yxj.org.cn/2020062914422100014.png" title="" alt="" style="font-family: -apple-system-font, BlinkMacSystemFont, &quot;Helvetica Neue&quot;, &quot;PingFang SC&quot;, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei UI&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; padding: 0px; margin: 0px auto; border-style: none; width: auto;"/><br/></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><br/></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span class="ysz-ueditor-title-one" style="font-size: 18px; line-height: 28px; font-weight: bold; color: rgb(215, 0, 15); text-align: left;">总结</span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; white-space: normal; font-size: 16px; line-height: 25.5px; color: rgb(0, 0, 0); word-break: break-word; max-width: 100%; min-height: 1em; caret-color: rgb(51, 51, 51); font-family: -apple-system-font, BlinkMacSystemFont, &quot;Helvetica Neue&quot;, &quot;PingFang SC&quot;, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei UI&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif; letter-spacing: 0.544px; text-size-adjust: auto; overflow-wrap: break-word !important; box-sizing: border-box !important;"><br/></p><p><span style="font-size: 16px;">1.&nbsp;半衰期是指血浆药物浓度下降一半所需要的时间</span>。&nbsp;奥硝唑&nbsp;和&nbsp;替硝唑&nbsp;的血浆消除半衰期均比&nbsp;甲硝唑&nbsp;的消除半衰期长，与后者相比，前两者能减少患者服药次数，方便患者的使用，从而提高患者的依从性。</p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span style="font-size: 16px;"><br/></span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span style="font-size: 16px; padding: 0px; margin: 0px; overflow-wrap: break-word; font-family: -apple-system-font, BlinkMacSystemFont, &quot;Helvetica Neue&quot;, &quot;PingFang SC&quot;, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei UI&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif;">2.&nbsp;抗菌强度方面，更多文献证明了替硝唑和奥硝唑抗厌氧菌、阴道滴虫等方面的抗菌活性较甲硝唑高，且起效快，值得推广使用。<br/></span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span style="font-size: 16px; padding: 0px; margin: 0px; overflow-wrap: break-word; font-family: -apple-system-font, BlinkMacSystemFont, &quot;Helvetica Neue&quot;, &quot;PingFang SC&quot;, &quot;Hiragino Sans GB&quot;, &quot;Microsoft YaHei UI&quot;, &quot;Microsoft YaHei&quot;, Arial, sans-serif;"><br/></span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span style="font-size: 16px;">3.&nbsp;不良反应：</span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span style="font-size: 16px;">硝基咪唑类药物的不良反应主要为以下几个方面</span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span style="font-size: 16px;"><br/></span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span style="font-size: 16px;">（1）消化系统症状：常见，包括胃部不适、食欲下降、口腔金属味等；</span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span style="font-size: 16px;">（2）神经系统；头痛及困倦、眩晕、颤抖、四肢麻木、痉挛和精神错乱等；</span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span style="font-size: 16px;">（3）过敏反应：皮疹、瘙痒等；</span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;">（4）其他：白细胞减少。三者的不良反应发生率及轻重程度各有不同，其中甲硝唑不良反应常见且较重，替硝唑‍和&nbsp;奥硝唑&nbsp;不‍良反应少见且轻微。</p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span style="font-size: 16px;"><br/></span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span style="font-size: 16px;">4.&nbsp;三者均具有以下相互作用</span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span style="font-size: 16px;"><br/></span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span style="font-size: 16px;">（1）抑制抗凝药华法林的代谢，增强抗凝药效；同用时，注意观察出血症状并调整给药剂量；</span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span style="font-size: 16px;">（2）与‍&nbsp;苯妥英钠&nbsp;、苯巴比妥等肝药酶诱导剂合用时，可加快三者的代谢，使血药浓度减慢，并使&nbsp;苯妥英钠&nbsp;排泄减慢；‍</span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span style="font-size: 16px;">（3）与西咪替丁等肝药酶抑制剂合用时，可减慢三者的代谢，延长半衰期，可根据血药浓度调整剂量。因此，应避免与上述药物连用，如必须连用，则应密切监测患者，及时调整剂量。</span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span style="font-size: 16px;"><br/></span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><span style="font-size: 16px;">5.&nbsp;双硫仑反应：服药过程中饮酒，药物会抑制酒精代谢，出现腹痛、呕吐、头痛等症状。‍&nbsp;甲硝唑&nbsp;和&nbsp;替硝唑&nbsp;可‍能出现上述反应，因此，用药期间应戒酒。</span></p><p style="padding: 0px; margin-top: 0px; margin-bottom: 0px; overflow-wrap: break-word; white-space: normal; font-size: 16px; line-height: 28px; color: rgb(0, 0, 0); word-break: break-word;"><br/></p>

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