药物诱发癫痫样发作148例文献回顾性分析  

Drug-induced epileptiform seizures:retrospective analysis of 148 cases in literature

作　　者：马建丽[1] 任红业[2] 梁树立[3] 

机构地区：[1]解放军总医院第一附属医院药剂药理科,北京100037 [2]解放军总后勤部第二门诊部,北京100071 [3]解放军总医院第一附属医院神经外科,北京100037

出　　处：《药物不良反应杂志》2008年第4期252-255,共4页Adverse Drug Reactions Journal

摘　　要：目的:分析药物诱发癫痫样发作的相关危险因素。方法:检索1997年至2007年CNKI和CMB收载的药物诱发癫痫样发作患者148例的资料,对患者的年龄、性别、原患疾病、诱发癫痫药物、药物剂量、联合用药,癫痫发作类型、发作时间和持续时间及转归进行回顾性分析。结果:148例患者中,男82例,女66例,平均年龄(40.16±24.08)岁,有癫痫病史15例。诱发癫痫样发作居前三位的药物为抗微生物药物82例(其中喹诺酮类39例),占55.41%,中枢神经系统药物34例(其中抗精神病药物20例),占22.97%,麻醉药8例(其中氯胺酮6例),占5.41%;药物诱发癫痫样发作类型以全面强直-阵挛性发作为主,共120例(81.08%),其次为复杂部分性发作15例(10.14%);患者年龄<19岁32例(21.6%),年龄≥60岁52例(35.14%);超剂量用药21例(14.19%);45例联合用药患者中有10例出现癫痫样发作。癫痫发作时间为首次用药后3 min至6个月,持续时间为4 s至20 min。147例癫痫样发作患者经停药及对症处理症状均好转或痊愈,1例因肺部感染,循环衰竭死亡。结论:药物诱发癫痫样发作可能与药物对中枢神经系统的作用、患者的年龄(老年或未成年)、癫痫病史、原患疾病、药物剂量过大以及联合用药等因素相关。Objective： To analyze the related risk factors for drug-induced epileptiform seizures. Methods： The data of 148 patients with drug-induced epileptiform seizures were collected from CNKI and CMB between 1997 and 2007. The risk factors for druginduced epileptiform seizures were analyzed retrospectively, including age, sex, and primary diseases of patients; causative drugs, dosage, and drug combination; type, onset time, duration, and prognosis of seizures. Results： Of the 148 patients, 82 were men, 66 were women. Their average age was （40.16 ± 24.08） years. Fifteen patients of them had history of epilepsy . The first three kinds of drugs that may induce epileptiform seizures were antimicrobial drugs, drugs acting on the central nervous system, and anesthetics. Eighty-two cases （ 55.41% ） of epileptiform seizure were caused by antimicrobial drugs, and quinolones accounted for 39 of 82 cases. Thirty-four cases （22.97%） were caused by drugs acting on the central nervous system, and antipsychotic accounted for 20 of 34 cases. Eight cases （5.41%） caused by anesthetics, and ketamine accounted for 6 of 8 cases. The most common type of epileptiform seizures was generalized tonic-clonic seizure （ 120 cases, 81.08% ）, followed by complex partial seizure （ 15 cases, 10.14% ）. The patients 〈 19 years of age were 32 cases （21.6%）, and the patients ≥60 years of age were 52 cases （35.14%）. The patients receiving drug overdose were 21 cases （ 14.19% ）. Of 45 patients receiving drug combination, 10 patients developed epileptiform seizures. The time of seizure onset was 3 minutes to 6 months after the first administration of the drug, lasting from 4 seconds to 20 minutes. After drug withdrawal or symptomatic therapy, 147 patients with epileptiform seizures improved or recovered, and one patient died from pulmonary infections and circulatory failure. Conclusion： The risk factors for drug-induced factors include the effects of drugs on the central nervous system, patient＇s age （olde

关 键 词：癫痫样发作 文献分析 不良反应 危险因素 

分 类 号：R742.1[医药卫生—神经病学与精神病学]