我院奥氮平致中枢神经系统不良反应30例分析

发布时间：2018-11-26 20:40

【摘要】：目的:了解奥氮平致中枢神经系统药品不良反应(ADR)的特点,为临床安全、合理用药提供参考。方法:收集我院2004-2015年上报国家ADR监测中心的30例奥氮平致中枢神经系统ADR报告,对患者的一般情况、药物治疗情况、ADR情况、治疗措施及转归等进行统计分析。结果:30例奥氮平致中枢神经系统ADR报告中,女性患者多于男性(22/8);患者年龄主要集中在21~40岁(10例,33.3%)。原患疾病以精神分裂症为主(18例,60.0%)。发生ADR时,奥氮平的平均剂量为(18.0±7.0)mg/d;在日剂量20 mg时发生ADR的例数最多(8例,26.7%)。主要的ADR为锥体外系反应(22例,73.3%)。患者出现ADR后,大部分采取减量或停用奥氮平、换用其他抗精神病药,并积极作对症、支持治疗等处理,患者症状均缓解或恢复正常。结论:奥氮平所致中枢神经系统ADR中,锥体外系反应占比较大;在日剂量较小时仍有发生ADR的可能。女性更容易出现中枢神经系统ADR;在治疗1月内,应密切监测ADR情况。临床应用奥氮平时,应严格掌握适应证,并注意观察ADR,保障患者用药安全。
[Abstract]:Objective: to investigate the characteristics of adverse drug reactions (ADR) in central nervous system induced by olanzapine in order to provide reference for clinical safety and rational drug use. Methods: 30 cases of ADR of central nervous system caused by olanzapine from 2004 to 2015 were collected and analyzed. The general situation, drug treatment, ADR, treatment measures and outcome of the patients were statistically analyzed. Results: in 30 cases of ADR induced by olanzapine, the number of female patients was more than that of men (22 / 8), and the age of the patients was mainly 21 ~ 40 years (10 cases, 33.3%). Schizophrenia was the main disease (18 cases, 60.0%). The average dose of olanzapine was (18.0 卤7.0) mg/d; at the daily dose of 20 mg (8 cases, 26.7%). The main ADR was extrapyramidal reaction (22 cases, 73.3%). After ADR, most of the patients were treated by reducing or stopping olanzapine, switching to other antipsychotics, and actively treating symptoms and supporting treatment, all patients' symptoms were relieved or returned to normal. Conclusion: the extrapyramidal system reaction in central nervous system ADR caused by olanzapine is relatively large, and ADR may still occur at a relatively small daily dose. Women are more likely to develop ADR; in the central nervous system within one month of treatment, ADR should be closely monitored. In clinical application, indications should be strictly grasped and ADR, should be observed to ensure the safety of drug use.
【作者单位】：首都医科大学附属北京安定医院药事部;国家精神心理疾病临床医学研究中心;精神疾病诊断与治疗北京市重点实验室;首都医科大学附属北京安定医院院部办公室;
【基金】：北京市科技计划项目(No.Z151100004015180) 北京安定医院人才培养项目(No.YR-G201508)
【分类号】：R971

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