美罗培南中枢神经系统不良反应病例及文献分析  

Adverse Drug Reaction of Central Nervous System Induced by Meropenem:A Case Report and Literature Analysis

作　　者：吴雪娇 闫鸿丽 郑鹏程[3] 李婧炜 杨雪婷[3] WU Xuejiao;YAN Hongli;ZHENG Pengcheng;LI Jingwei;YANG Xueting(College of Pharmacy,Dali University,Dali,Yunnan,China 671000;Teaching and Research Office of Pharmacy,Yunnan University of Chinese Medicine,Kunming,Yunnan,China 650500;The First People's Hospital of Yunnan Province·The Affiliated Hospital of Kunming University of Science and Technology,Kunming,Yunnan,China 650032)

机构地区：[1]大理大学药学院,云南大理671000 [2]云南中医药大学药剂教研室,云南昆明650500 [3]云南省第一人民医院·昆明理工大学附属医院药学部,云南昆明650032

出　　处：《中国药业》2022年第20期116-121,共6页China Pharmaceuticals

基　　金：云南省科技厅科技计划项目[202101AZ070001-036];云南省教育厅科学研究基金项目[2016ZDX022];云南省第一人民医院“昆华·奥新”科技计划项目[2014QN004]。

摘　　要：目的为预防和管理美罗培南的中枢神经系统(CNS)不良反应提供依据。方法纳入云南省第一人民医院1例肺间质纤维化并支气管扩张伴感染患者使用美罗培南出现癫痫样症状的病例,并检索中国知网(CNKI)、维普数据库(VIP)及Embase,PubMed,Wiley,Sprinkle数据库,检索时限为各数据库自建库起至2021年10月,收集美罗培南CNS不良反应的个案报道,分析该不良反应的特点及规律。结果共纳入文献13篇,涉及患者16例,共纳入17例。其中,男5例,女12例;年龄6个月至100岁,其中>60岁8例(47.06%);美罗培南用量超常规剂量1例(5.88%);给药后1~4 d出现神经毒性症状16例(94.12%);CNS不良反应的表现以癫痫样症状为主,共10例(58.82%)。患者经停药、对症治疗后症状均缓解。结论临床使用美罗培南应重视神经毒性有关的高危因素,发生CNS不良反应时应及时合理应对。Objective To provide evidence for the prevention and management of adverse drug reaction(ADR)of central nervous system(CNS)induced by meropenem.Methods An epileptiform case induced by meropenem in a patient with pulmonary interstitial fibrosis,bronchiectasis and infection in the First People’s Hospital of Yunnan Province was included in the study.CNKI,VIP and Embase,PubMed,Wiley and Sprinkle databases were retrieved from the inception to October 2021 to collect the case reports of ADR of CNS induced by meropenem,and the characteristics and rules of the ADR were analyzed.Results A total of thirteen studies were included,including sixteen patients and twenty ADRs caused by meropenem.Among them,there were five males and twelve females.The age ranged from 6 months to 100 years,of which eight cases(47.06%)were over 60 years old.Only one case(5.88%)was treated by overdose of meropenem,sixteen cases(94.12%)had neurotoxicity symptoms within 1-4 d after administration.The manifestations of ADR of CNS was mainly epileptic symptoms(10 cases,58.82%).The patients’symptoms were relieved after drug withdrawal and symptomatic treatment.Conclusion The high-risk factors related to neurotoxicity should be paid attention to in the clinical use of meropenem,and the ADR of CNS should be dealt with timely and reasonably.

关 键 词：美罗培南 癫痫 神经毒性 中枢神经系统 药品不良反应 文献分析 

分 类 号：R969.3[医药卫生—药理学] R978.1[医药卫生—药学]