头孢吡肟致神经毒性46例文献分析

Cefepime-induced Neurotoxicity:Literature Analysis of 46 Cases

目的:分析头孢吡肟致神经毒性的临床特点,为临床合理使用头孢吡肟提供参考。方法:检索1997～2009年医学文献中有关头孢吡肟所致神经毒性的病例报道,对46例患者的年龄、性别、原患疾病、用药情况、不良反应发生时间、临床症状和转归进行分析。结果:46例患者中,男性25例,女性21例,平均年龄(59.56±18.84)岁(1例年龄不详)。头孢吡肟单用38例,与其它药物联用8例,全部为静脉给药。46例中有32例慢性肾功能不全患者,其中10例超过规定用量(1例剂量不祥)。头孢吡肟所致神经毒性主要表现为脑病、肌阵挛和癫痫。神经毒性出现时间为(4.39±2.18)d(2例时间不详)。36例经停药及对症处理后症状好转或痊愈,平均治愈时间为(2.67±2.64)d。结论:临床应重视头孢吡肟的抗菌效应及其神经毒性的危害性。

OBJECTIVE：To analyze the clinical characteristics of cefepime-induced neurotoxicity and to provide reference for rational use of cefepime.METHODS：Medical records of cefepime-induced neurotoxicity were collected from medical literatures from 1997 to 2009.Age and gender of 46 patients,primary diseases,drug usage,onset time of ADR,clinical symptom and prognosis were analyzed.RESULTS：Of 46 patients,25 cases were male and 21 female.Their average age was （59.56±18.84） years old （unknown age of 1 case）.38 cases received cefepime alone and 8 cases cefepime combined with other drugs.All patients were administered by intravenous infusion.Of 46 patients,32 patients suffered from chronic renal failure,among which 10 patients received overdosage of medicine （unknown dosage of 1 case）.Clinical symptoms of cefepime-induced neurotoxicity were encephalopathy,myoclonus and epilepsy.The occurrence time of neurotoxicity was （4.39±2.18）d （unknown occurrence time of 2 cases）.The symptoms of 36 cases were relieved and cured after drug withdrawal and treatment with mean cure duration of （2.67±2.64）d.CONCLUSION：Great importance should be attached to the antibacterial effects of cefepime and cefepime-induced neurotoxicity.