5-羟色胺综合征的临床特征、诊断及防治  

Serotonin syndrome: clinical characteristics, diagnosis, treatment, and prevention

作　　者：张小澍[1] 鱼爱和[1] 耿玉兰[1] 

机构地区：[1]解放军第261医院神经内科,北京100094

出　　处：《药物不良反应杂志》2007年第3期195-200,共6页Adverse Drug Reactions Journal

摘　　要：5-羟色胺综合征是一种由治疗药物引起的可能危及生命的不良反应。发生机制为5-羟色胺(5-HT)在神经系统内积蓄,过度激活突触后5-HT受体,导致5-HT能神经系统活动增强,其临床特征为精神障碍、自主神经功能亢进及神经肌肉功能异常。本综合征常发生于抗抑郁药联用或与其他药物联用时,主要依据临床表现诊断。治疗包括停撤可疑药物、密切观察、控制激越行为、给予5-HT拮抗剂、对症治疗、并发症的处理等。本综合征重在预防。The serotonin syndrome is a potentially life-threatening adverse reactions that results from therapeutic drug use. The mechanisms are attributed to the increase on activity of serotonergic system because 5-hydroxytryptamine （5-HT） accumulates in nervous system and 5-HT postsynaptic receptors arc overactivated. The clinical feature is described as a clinical triad of mental-status changes, autonomic hyperactivity, and neuromuscular abnormalities. The syndrome often occurs in coadminstration among antidepressants or combination with other drugs. The diagnosis of the serotonin syndrome is mainly based on the clinical manifestation. Management of the serotonin syndrome involves the cessation of precipitating drugs, improvement of monitoring, control of agitation, administration of 5-HT antagonists, symptomatic treatment, the control of complication, etc. The prevention of the syndrome is more important than the treatment.

关 键 词：5-羟色胺综合征 发病机制 诊断 治疗 预防 

分 类 号：R595.3[医药卫生—内科学]