抗感染药物致中枢神经系统不良反应503例国内文献分析

Analysis of Domestic Literatures on 503 Cases of Central Nervous System Adverse Reactions Caused by Anti-infective Drugs

目的:了解抗感染药物致中枢神经系统不良反应(ADR)的情况,分析其特点和相关因素,促进临床安全用药。方法:检索1999~2016年"中国知网、万方医学数据库、国家药品不良反应监测中心"抗感染药物致中枢神经系统不良反应病例,并进行统计分析。采用文献学计量方法,对国内公开报道的503例抗感染药物所致ADR进行总结性分析。结果:药物以喹诺酮类和头孢菌素类为主,共348例,占总病例69.18%,喹诺酮类中以左氧氟沙星最多,共86例,占总病例17.10%;头孢菌素类中以头孢吡肟和头孢他啶最多,共37例,占总病例7.36%,其中21例为肾衰或尿毒症血液透析患者。碳青霉烯类以亚胺培南/西司他丁最多,共32例,占总病例的6.36%。发生ADR最多的时间为用药1~7 d后,共325例,占总病例的64.61%。结论:抗感染药物致中枢神经系统ADR比较多见,症状表现多样,尤以老年人群居多,临床在使用时要多加注意。

Objective： To understand the adverse drug reactions（ ADR） of the anti-infection drugs of the central nervous system,analyzes its characteristics and related factors,promote clinical rational drug use. Methods： To retrieve and analyze the cases of the adverse reactions of the central nervous system caused by the anti-infective drugs from 1999 to2016 in CNKI,Wanfang Data and China＇s National Center for adverse drug reaction monitoring. Results： Drugs to quinolone and cephalosporin,a total of 348 cases,69. 18% cases in total,quinolones levofloxacin by most,a total of 86 cases,total 17. 10% cases; cephalosporins,cefepime and ceftazidime,up to 37 cases,accounting for the total number of cases,of which 21 cases of patients with renal failure or uremia hemodialysis patients. Carbapenem to imipenem/cilastatin,a total of 32 cases,accounting for 6. 36% of the total cases. The most time of ADR was 1-7 d after treatment with a total of 325 cases,accounting for about 64. 61% of the total cases. Conclusion： Anti infective drugs caused by the central nervous system ADR was more common,the symptoms were diverse,especially in the elderly more gregarious,clinical use should pay more attention.