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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 factors of epileptic seizures in patients with levofloxacin, so as to provide a reference for clinical safe medication. Methods: Retrieve the domestic and foreign medical database, download the original report of the case, statistics of the patient’s sex, age, route of administration and dosage, the combination of medication and the occurrence of epileptic seizure latency and clinical manifestations, treatment and prognosis, analysis of their causes Characteristics of epilepsy with risk factors and recommendations for safe drug use. Results: A total of 45 cases of levofloxacin-induced epileptic seizures were retrieved. The analysis showed that 80% of middle-aged and elderly patients over 41 years of age and 64.44% of female patients were found. Epilepsy-like symptoms were mainly occurred in major episodes. The clinical manifestations were mainly tetany , Foaming at the mouth, eyes upside down, loss of consciousness, etc .; intravenous infusion of drugs accounted for more than 80%; use of hyper-indications and with theophylline preparations, cephalosporins, antidepressants and other combinations are caused An important risk factor for epileptic seizures. Conclusion: It is an important measure to reduce the risk of medication by correctly choosing the medication population, avoiding the combination medication, strengthening the medication monitoring, and actively treating the clinical symptoms of epileptic seizures in patients.