【摘要】：目的:了解奧氮平致中樞神經(jīng)系統(tǒng)藥品不良反應(yīng)(ADR)的特點,為臨床安全、合理用藥提供參考。方法:收集我院2004-2015年上報國家ADR監(jiān)測中心的30例奧氮平致中樞神經(jīng)系統(tǒng)ADR報告,對患者的一般情況、藥物治療情況、ADR情況、治療措施及轉(zhuǎn)歸等進(jìn)行統(tǒng)計分析。結(jié)果:30例奧氮平致中樞神經(jīng)系統(tǒng)ADR報告中,女性患者多于男性(22/8);患者年齡主要集中在21~40歲(10例,33.3%)。原患疾病以精神分裂癥為主(18例,60.0%)。發(fā)生ADR時,奧氮平的平均劑量為(18.0±7.0)mg/d;在日劑量20 mg時發(fā)生ADR的例數(shù)最多(8例,26.7%)。主要的ADR為錐體外系反應(yīng)(22例,73.3%)。患者出現(xiàn)ADR后,大部分采取減量或停用奧氮平、換用其他抗精神病藥,并積極作對癥、支持治療等處理,患者癥狀均緩解或恢復(fù)正常。結(jié)論:奧氮平所致中樞神經(jīng)系統(tǒng)ADR中,錐體外系反應(yīng)占比較大;在日劑量較小時仍有發(fā)生ADR的可能。女性更容易出現(xiàn)中樞神經(jīng)系統(tǒng)ADR;在治療1月內(nèi),應(yīng)密切監(jiān)測ADR情況。臨床應(yīng)用奧氮平時,應(yīng)嚴(yán)格掌握適應(yīng)證,并注意觀察ADR,保障患者用藥安全。
[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 鹵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.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京安定醫(yī)院藥事部;國家精神心理疾病臨床醫(yī)學(xué)研究中心;精神疾病診斷與治療北京市重點實驗室;首都醫(yī)科大學(xué)附屬北京安定醫(yī)院院部辦公室;
【基金】：北京市科技計劃項目(No.Z151100004015180) 北京安定醫(yī)院人才培養(yǎng)項目(No.YR-G201508)
【分類號】：R971

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