甲泼尼龙致系统性红斑狼疮患者精神障碍4例  

Mental disorder due to methylprednisolone in patients with systemic lupus erythematosus：report of 4 cases

作　　者：任昊[1] 赵进军[1] 林静丽[1] 崔丹瑜[1] 赖伟男[1] 黄琴[1] 杨敏[1] 

机构地区：[1]南方医科大学南方医院风湿免疫科,广州510515

出　　处：《药物不良反应杂志》2015年第3期232-234,共3页Adverse Drug Reactions Journal

基　　金：南方医科大学南方医院院级教育研究课题（14NJ-MS11）

摘　　要：4例女性患者（年龄分别为17、14、25和20岁）因系统性红斑狼疮（例1、2合并Ⅳ型狼疮性肾炎）接受大剂量甲泼尼龙冲击治疗，静脉滴注甲泼尼龙0.5 g/d，连续3 d，之后改为口服泼尼松1~2 mg·kg-1·d-1。4例患者分别在用药5~18 d 后出现不同程度精神障碍，表现为兴奋、言语增多、焦虑、躁狂、不能入睡，甚至出现被害妄想、自杀倾向等。逐渐减少激素用量并加用镇静及抗精神病药物治疗19 d至2.5个月，4例患者均完全恢复正常。Four female patients（ aged 17,14,25,and 20,respectively）with systemic lupus erythematosus（ cases 1 and 2 were complicated with type IV lupus nephritis ） received high-dose methylprednisolone pulse therapy,which included an IV infusion of methylprednisolone 0. 5 g daily for 3 days,and then instead of prednisone 1-2 mg·kg-1 ·d-1 orally. Five to eighteen days after administration, the four patients developed the symptoms of mental disorders,such as exciting,garrulous,anxiety,mania, hardly fall asleep,even delusion of persecution and suicidal tendency. The four patients returned to normal completely after 19 days to 2. 5 months by decreasing the dosage of the steroid gradually and the treatment nbsp;with sedatives and antipsychotic drugs.

关 键 词：甲泼尼龙 红斑狼疮 系统性 精神障碍 

分 类 号：R758.62[医药卫生—皮肤病学与性病学]