奋乃静致高催乳素血症

Perphenazine-induced hyperprolactinemia

1例22岁女性患者,因病毒性脑炎伴症状性癫痫入院,予阿昔洛韦0.5 g加入0.9%氯化钠注射液250 ml静脉滴注,1次/8 h;奋乃静4 mg,1次/8 h口服;奥氮平每早2.5 mg、每晚5 mg口服;丙戊酸钠0.5 g,1次/12 h口服。入院前曾因病毒性脑炎,已连续口服奋乃静(4 mg,1次/8 h)和奥氮平(5 mg,每晚1次)7 d。入院第5天患者出现泌乳,第6天催乳激素(PRL)水平为5.93 nmol/L,当日开始逐日递减奋乃静2 mg,至入院第12天停用,阿昔洛韦、奥氮平和丙戊酸钠继续应用。停药当日PRL为4.11 nmol/L。停用奋乃静第8天患者泌乳症状消失,PRL水平恢复正常(1.28 nmol/L)。

A 22-year-old woman was hospitalized with viral encephalitis accompanied by symptomatic epilepsy and received an IV infusion of acyclovir 0.5 g in 0. 9% sodium chloride 250 ml every eight hours, oral perphenazine 4 mg every eight hours, oral olanzapine 2.5 mg every morning and 5 mg every night, and oral valproate sodium 0.5 g every twelve hours. Before admission, she had been prescribed oral perphenazine 4 mg every eight hours and olanzapine 5 mg every night for 7 days because of viral encephalitis. On day 5 after admission, she developed galactorrhea and, on day 6, her prolactin （PRL） level was 5.93 nmol/L. Then the dose of perphenazine was reduced by 2 mg each day and, until twelve days after admission, perphenazine was stopped. However, acyclovir, olanzapine, and valproate sodium were continued. On the day of drug withdrawal, her PRL level was 4. 11 nmol/L. On day 8 of perphenazine discontinuation, her symptom of galactorrhea vanished and the PRL level returned to normal range （ 1.28 nmol/L）.