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目的探讨尿毒症患者使用头孢类抗生素过程中发生精神-神经症状的原因。方法对尿毒症维持性血液透析患者中应用头孢他啶后出现神经-精神症状5例的临床资料进行分析。结果本组均为尿毒症维持性血液透析患者,均因感染使用头孢他啶,使用剂量符合药典规定,并作适当减量,均于用药3～5d即出现神经症状,如不自主震颤、躁动不安、幻视等,停用该药或改其他类抗生素,临床症状消失。结论慢性肾功能衰竭患者药物排泄速率减慢、血浆半衰期延长,加上头孢类抗生素与血浆蛋白结合、分布及代谢转化过程的改变对其代谢产生的影响,是造成药物在中枢神经系统内累积,发生精神-神经症状的主要原因。
Objective To investigate the causes of neuropsychiatric symptoms during the use of cephalosporins in uremic patients. Methods The clinical data of 5 patients with neuropsychiatric symptoms after ceftazidime in patients with maintenance hemodialysis of uremia were analyzed. Results This group were patients with uremic maintenance hemodialysis patients were infected with ceftazidime, the use of doses consistent with the provisions of the Pharmacopoeia, and appropriate reduction, are in the medication 3 ~ 5d that neurological symptoms, such as involuntary tremors, restlessness, Vision, etc., disable the drug or change other antibiotics, clinical symptoms disappear. Conclusions Patients with chronic renal failure have a slower drug excretion rate and longer plasma half-life. The combination of cephalosporins and plasma proteins, the changes of their metabolism and metabolic processes have an effect on the metabolism of the drug, resulting in the accumulation of drugs in the central nervous system. The main cause of mental-neurological symptoms.