60例利培酮致锥体外系不良反应特点分析  

Analysis of characteristics of 60 cases of Risperidone-induced extrapyramidal side effect

作　　者：张明辉 张红卫 陈金兰 黄文灿 薛欣杰 庄淑丽 ZHANG Ming-hui;ZHANG Hong-wei;CHEN Jin-lan;HUANG Wen-can;XUE Xin-jie;ZHUANG Shu-li(Department of Pharmacy,Mental Hospital of Guangzhou Civil Affairs Bureau,Guangdong Province,Guangzhou 510430,China)

机构地区：[1]广州市民政局精神病院药剂科,广东广州510430

出　　处：《中国当代医药》2021年第25期155-158,共4页China Modern Medicine

基　　金：广东省中医药局科研项目(20191243)。

摘　　要：目的探讨利培酮致锥体外系不良反应(EPS)的临床特征及用药特点。方法回顾性分析2010—2019年广州市民政局精神病院上报至国家药品不良反应监测中心的60例利培酮致EPS的病例的一般资料(性别、年龄、体重),用药方法(适应症、用药剂量、用药时间、合并用药情况),EPS临床症状、治疗措施和转归。结果从年龄分布来看,60例药物不良反应(ADR)报告中,壮年(41~50岁)、青年(21~30岁)和中年(31~40岁)占比较高,分别为18%、17%和13%;从性别来看,利培酮所致EPS在女性患者中发生率为65.00%。分析不同片剂种类,口服普通片剂引起不良反应例数最多(26,例,43.33%),口崩片次之(24例,40.00%);从剂量分析,当利培酮的日剂量在4~6 mg范围内时EPS发生风险较高,未观察日剂量在6 mg以上的EPS发生情况;从用药方式来看,利培酮单一用药时发生EPS较多,为39例(65.00%);从发生时间分析,53.33%病例EPS发生在用药1个月内,其中30.00%的病例在用药10 d内出现;本次研究的60例EPS中以帕金森综合征为主,为(43例,71.67%);四肢肌张力增高(38例,63.33%)也较为多见。出现EPS后,41.67%的患者临床症状可随治疗的持续自行消退,11例患者经对症处理并减量后好转,7例患者需更换其他抗精神病药物治疗。结论利培酮所致EPS在中年患者中发生率较高,多出现在用药1个月内,单一用药较容易发生EPS,对症治疗并减量有助于缓解EPS临床症状,建议加强对高风险患者的临床监测,避免不良反应的发生。Objective To analyze the clinical characteristics and medication characteristics of risperidone-induced extrapyramidal side effect(EPS).Methods The general data(sex,age,weight),medication methods(indications,dosage of medication,time of medication,combined medication)and clinical symptoms,treatment measures and outcome of 60 cases of Risperidone-induced EPS reported from Mental Hospital of Guangzhou Civil Affairs Bureau to the National Adverse Drug Reaction Monitoring Center from 2010 to 2019 were retrospectively analyzed.Results From the perspective of age distribution,among 60 adverse drug reaction(ADR)reports,the proportions of prime of life(41-50 years old),youth(21-30 years old)and middle-aged(31-40 years old)were relatively high,18%,17%and 13%,respectively.From the perspective of sex,the incidence of EPS caused by Risperidone was higher in female patients,which was 65.00%.According to the analysis of different types of tablets,the number of adverse reactions caused by oral tablets was the largest in 26 cases(43.33%),followed by orally disintegrating tablets of 24 cases(40.00%).From the dose analysis,when the daily dose of Risperidone was in the range of 4-6 mg,the risk of EPS was relatively high,and we did not observe the occurrence of EPS with a daily dose of 6 mg or more.From the perspective of the way of medication,there were more EPS in 39 cases(65.00%)when Risperidone was used alone.From the analysis of the time of occurrence,53.33%of the cases of EPS occurred within 1 month of medication,and 30.00%cases occurred within 10 days of medication.Among the 60 cases of EPS in this study,Parkinson′s syndrome was the main type(n=43,71.67%);increased muscle tone of the extremities(n=38,63.33%)was also common.After the occurrence of EPS,41.67%of the patients′clinical symptoms subsided spontaneously as the treatment continued,11 patients improved after symptomatic treatment and dose reduction,and 7 patients needed to be replaced with other antipsychotic drugs.Conclusion The incidence of EPS caused by Risperid

关 键 词：利培酮 锥体外系 不良反应 抗精神病药 

分 类 号：R971[医药卫生—药品]