摘要
目的通过分析12例神经阻滞剂恶性综合征(neuroleptic malignant syndrome,NMS)患者的临床症状、治疗及预后情况,探讨NMS可能的发病机制,指导临床正确和及时的用药。方法对确诊(12例)或疑似(21例)NMS病例早期给予多巴胺受体通路的激活治疗,对临床症状的严重程度及患者转归进行回顾性分析。结果确诊NMS患者中,有7例(58.33%)患者经治疗于1周内临床缓解,最终死亡4例(33.33%);疑似NMS患者中,有13例(76.19%)患者经治疗于1周内临床缓解,最终死亡5例(23.81%)。给予对症支持治疗联合多巴胺治疗组患者病死率低于单纯给予对症支持治疗组的病死率。有无肾功能衰竭(P<0.05)及是否接受多巴胺治疗(P<0.05)与死亡终点显著相关。结论多巴胺受体通路抑制可能是NMS发病的重要机制之一。不论是确诊或疑似NMS病例早期给予激活多巴胺受体通路的药物治疗对缓解疾病症状和降低病死率显得尤为关键。
Objective To study the possible pathogenesis of neuroleptic malignant syndrome（NMS）by analyzing clinical symptoms,treatments,and prognosis of 12 cases of NMS. Methods Twelve confirmed and 21 suspected cases of NMS were given the therapy of dopamine receptor pathway activation in early stage,and clinical symptoms,severity and prognosis were retrospectively analyzed. Results In confirmed NMS cases 7（58.33%）patients had clinical remission one week after treatment,and consequently there were 4 deaths（33.33%）.In suspected NMS cases 13（76.19%）patients had clinical remission one week after week treatment,and consequently there were 5 deaths（23.81%）.The mortality of NMS cases receiving corresponding treatments including the therapy of dopamine receptor pathway activation was significantly lower than in those receiving corresponding treatments excluding the therapy of dopamine receptor pathway activation.There was significant correlation between renal failure（P0.05）and dopamine therapy（P0.05）with death. Conclusion The dysfunction of dopamine receptor pathway might play a significant role in the pathogenesis of NMS.It is important to perform dopamine receptor pathway activation treatment for both confirmed and suspected cases of NMS,in alleviating clinical symptoms and reducing mortality.
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2011年第5期607-610,共4页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
