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目的通过研究尿毒症透析患者使用复方感冒制剂而引发药物性脑病的临床特点及发病机制来指导复方感冒制剂在尿毒症患者中的正确使用。方法 12例血液透析患者使用复方感冒制剂而发生了药物性脑病的临床症状进行回顾性分析总结。结果 112例患者中,5例行连续肾脏替代疗法(CRRT)治疗,平均治疗时间为8~12 h,治疗2次后,精神症状消失。其他7例采用CRRT与血液透析联合血液灌流交替治疗(HP+HD),治疗4次后癫痫及意识障碍完全缓解。12例患者症状缓解平均时间为(6±2)d,各种生化指标、尿量、血压均恢复到服感冒制剂之前的状况。结论复方感冒制剂导致药物在尿毒症患者体内浓度升高,药物的半衰期延长,引发中毒症状,出现药物性脑病。
Objective To study the clinical features and pathogenesis of drug-induced encephalopathy caused by compound-cold preparations in patients with uremia and dialysis to guide the correct use of compound-cold preparations in uremic patients. Methods A retrospective analysis was made on the clinical symptoms of drug-induced encephalopathy in 12 patients with hemodialysis who received compound cold. Results Among the 112 patients, 5 patients underwent continuous renal replacement therapy (CRRT) with an average treatment time of 8 to 12 hours. After 2 times of treatment, psychiatric symptoms disappeared. The other 7 patients were treated with CRRT and hemodialysis combined with hemoperfusion (HP + HD). After 4 treatments, epilepsy and unconsciousness were completely relieved. The mean time to symptom relief in 12 patients was (6 ± 2) d, and various biochemical parameters, urine output and blood pressure were restored to those before taking the cold preparations. Conclusion Compound cold preparations lead to drug concentration in patients with uremia, drug half-life prolonged, causing symptoms of poisoning, drug-induced encephalopathy.