乙酰胆碱酯酶抑制剂罕见不良反应比萨综合征分析

Analysis of acetylcholinesterase inhibitors-induced rare adverse drug reaction Pisa syndrome

目的:探讨乙酰胆碱酯酶抑制剂(acetylcholinesterase inhibitors,AChEIs)致比萨综合征发生的临床表现、治疗及转归,为安全用药提供参考。方法:检索国内外相关数据库,收集AChEIs致比萨综合征的病例报道,对其临床特点进行汇总与分析。结果:纳入分析的病例共16例,涉及多奈哌齐11例、卡巴拉汀4例、加兰他敏3例;病例中男3例、女13例;比萨综合征发生在服药后的数小时至30个月,中位时间为4个月;发生比萨综合征后14例停药、1例减量、1例停用利培酮;患者转归的时间范围为3~90 d,中位时间为14 d;有2例可能与联合用药有关。结论:临床使用AChEIs应加强监测,警惕其单独使用及药物相互作用时导致的比萨综合征,以促进临床用药安全。

OBJECTIVE To explore the clinical characteristics,treatment and outcome of Pisa syndrome(PS)induced by acetylcholinesterase(AChEIs)inhibitors and provide reference for safe medication.METHODS The reports of PS induced by AChEIs were retrieved from domestic and foreign databases.RESULTS A total of 16 cases involved drug varieties including donepezil(n=11),rivastigmine(n=4),and galantamine(n=3).There were 3 males and 13 females in the cases,and the age range was 53 to 87 years with a median age of 72 years.PS occurred within a few hours to 30 months with a median occurrence time of 4 months.After the onset of PS,drug was discontinued in 14 patients,or with dose decrease in one patient,and risperidone was discontinued in one patient.The prognosis time was from 3 to 90 days with a median time of 14 days.Two cases may be associated with drug combination.CONCLUSION The clinical use of AChEIs should be monitored to be vigilant of PS caused by their single use or drug-drug interaction,so as to promote the safety of clinical drug use.