45例左氧氟沙星致癫痫样发作病例的报告分析及其对策  

Analysis of Reports in 45 Patients with Epilepsy Seizures induced by Levofloxacin and Its Countermeasures

作　　者：袁亚辉[1] 雷招宝[1] 

机构地区：[1]丰城市人民医院神经内科,江西丰城331100

出　　处：《抗感染药学》2016年第5期1082-1085,共4页Anti-infection Pharmacy

摘　　要：目的:分析左氧氟沙星致患者癫痫样发作的特点及其危险因素,为临床安全用药提供参考。方法:检索国内外医药数据库,下载病例报告原文,统计患者的性别、年龄、给药途径与剂量、联联用药情况以及发生癫痫样发作的潜伏期与临床表现、治疗与转归等,分析其致癫痫的特点与危险因素,并提出安全用药的建议。结果:共检索到左氧氟沙星致癫痫样发作的病例报告45例,分析发现41岁以上的中老年患者占80%,女性患者占64.44%;癫痫样症状以大发作为主,临床表现主要为四肢抽搐、口吐白沫、双眼上翻、意识丧失等;静脉滴注给药所致占80%以上;超适应证用药以及与茶碱类制剂、头孢菌素类、抗抑郁药等联用是致癫痫样发作的重要危险因素。结论:正确选择用药人群,避免联联用药,加强用药监测,积极处理患者出现的癫痫样发作的临床症状是降低用药风险的重要措施。Objective： To analyze the characteristics and risk l;actors of epilepsy seizures induced by lew）lloxacin and to provide the references for clinical safe drug use. Methods： To retrieve medical database both at home and abroad, download the original ease reports, to statistic the patient＇s gender, age, administrational routes and dosage of levofloxacin, the combinations of drugs, the latency for the onset of epilepsy seizures and the clinical manifestations, the treatment and outcomes, and analyze its characteristics and risk factors of epilepsy seizures, and puts forward the suggestions for the rational use of levofloxacin. Results： There have retrieved 45 cases of seizres induced by levofloxacin. We have found that the middle-aged and elderly patients over the age of 41 is as high as 80%, female patients ac- counted for 64.44%. The most of the seizures have been the grand mal.The of seizures of clinical manifestations have mainly been for limb tics, tbaming at the mouth, eyes turn（upturning or undering）, the patients were unconsciousness, etc.The proportion of intravenous inlilsion dosing is as high as 80% above. The ofl-label use of levofloxacin and the drug combinatcd with thcophyllines, cephalosporins, antidepressant drugs have been the important risk factors induced the epilepsy seizures by levofloxacin. Conclusion： There have been some measures to avoid the risks of using levoflox- acin that the correct selection of patients, avoiding the combinations with drugs that have risk of epilepsy seizures, to strengthen the drug safety monitoring, to treat actively the clinical symptoms of epilepsy seizures, ect..

关 键 词：左氧氟沙星 癫痫样发作 不良反应 危险因素 

分 类 号：R969.3[医药卫生—药理学]