慢性肾衰竭患者抗生素应用与神经精神症状表现

Antibiotic use and neuropsychiatric symptoms in patients with chronic renal failure

目的研究慢性肾衰竭病人抗生素应用与神经精神症状的表现。方法 2011年11月~2015年11月一共有61例慢性肾衰竭并发感染病人到我院治疗,根据使用抗生素的不同将其分成了头孢组（34例）以及非头孢组（27例）,比较两组病人神经精神症状的发生率以及治疗前后的简明精神病量表（BPRS）评分,并探究不同抗生素使用后病人的神经精神症状情况。结果头孢组以及非头孢组神经精神症状的总发生率分别为38.24%以及18.52%,头孢组神经精神症状的发生率显著的高于非头孢组（P〈0.05）;抗生素使用后两组的BPRS评分明显的升高,并且头孢组的显著高于非头孢组,比较差异均具有显著性（P〈0.05）;使用头孢拉定、头孢吡肟以及头孢哌酮三种头孢类抗生素后神经精神症状的发生率比较没有显著的差异（P〉0.05）。结论慢性肾衰竭感染病人在使用头孢类抗生素会大大提高精神神经症状的发生率,因此,在治疗中应结合患者情况,对抗生素的使用进行实时的调整,减少神经精神症状的发生。

Objective To study the relationship between antibiotic use and neuropsychiatric symptoms in patients with chronic renal failure. Methods From November 2011 to November 2015,a total of 56 patients with chronic renal failure complicated by infection come to our hospital for treatment. According to different antibiotics used,they were divided into cephalosporin group（34cases）and non-cephalosporin group（27 cases）. The incidence of neuropsychiatric symptoms and BPRS scores before and after treatment,and neuropsychiatric symptoms after using different cephalosporins in two groups were compared. Results The overall incidence of neuropsychiatric symptoms for cephalosporin group and non-cephalosporin group were 38.24% and 18.52% respectively,the incidence of neuropsychiatric symptoms cephalosporin group was significantly higher than the non-cephalosporin group（P〈0.05）;After the use of antibiotics,BPRS score for two groups significantly increased,and the non-cephalosporin group was significant higher than the cephalosporin group（P〈0.05）. In the three cephalosporins including cephradine,cefepime and cefoperazone,the incidence of neuropsychiatric symptoms was no significant difference（P〉0.05）. Conclusion Infected patients with chronic renal failure in the use of cephalosporins would greatly enhance the incidence of neuropsychiatric symptoms,therefore,should be combined in the treatment of the patient’s condition,the use of antibiotics for real-time adjustment to reduce neuropsychiatric symptoms.