表现为运动障碍和精神症状的复方氨酚烷胺不良反应10例临床分析

Misdiagnosis analysis of adverse reactions of compound paracetamol and amantadine hydrochloride capsules in ten patients with dyskinesia and psychiatric symptoms

目的分析复方氨酚烷胺胶囊中毒的神经精神症状。方法回顾性分析本院收治的10例表现为神经精神症状的复方氨酚烷胺胶囊中毒患者的临床资料。结果 10例患者平均发病年龄为(73.8±9.0)岁,有尿毒症病史者4例。主要起病症状为运动障碍及精神症状,运动障碍主要表现为姿势性震颤10例(100%),行走不稳1例(10.0%);精神症状主要表现为失眠5例(50.0%),幻觉6例(60.0%),精神欣快1例(10.0%),反应迟钝2例(20.0%)。常见伴随症状有言语含糊,头痛,心悸、出汗增多等。主要误诊疾病为颅内感染,尿毒症脑病,脑梗死,低血糖等。大多患者经停药、补液促进排泄后好转,少数患者经血液灌流联合血液透析后病情好转。结论复方氨酚烷胺胶囊中毒主要表现为运动障碍和精神症状,好发于老年及肾功能不全的人群中。

Objective To analyze the neuropsychiatric symptoms of the patients poisoned with compound paracetamol and amantadine hydrochloride capsules.Methods The clinical data of ten patients poisoned with compound paracetamol and amantadine hydrochloride capsules were retrospectively analyzed.Results The mean age of onset in ten patients was（73.8±9.0）years old,four cases of them had a history of uremia.The main symptoms included dyskinesia and psychiatric symptoms.Dyskinesia mainly presented with postural tremor（100%）and unsteady walking（10.0%）.Psychiatric symptoms mainly presented with insomnia（50.0%）,hallucinations（60.0%）,euphoric spirit（10.0%）and slow response（20.0%）.The concomitant symptoms included vague words,headache,palpitations and sweating.Major misdiagnosed diseases included intracranial infection,uremic encephalopathy,cerebral infarction and low blood sugar.Most of the patients recovered after drug withdrawal and fluid replacement,a minority of them recovered after the blood perfusion combined with hemodialysis.Conclusion The patients poisoned with compound paracetamol and amantadine hydrochloride capsules mainly presented with dyskinesia and psychiatric symptoms,who were prone to be found in the elderly and the patients with renal insufficiency.