摘要
目的:探讨药物诱发/加重重症肌无力(MG)的临床特点,为临床安全用药提供参考。方法:检索2000年1月~2017年12月PubMed、中国知网(CNKI)、维普中文科技期刊数据库(VIP)和万方数据库(Wanfang)等国内外数据库,获得药物诱发/加重MG的个案病例文献,对诱发/加重MG的药物种类、名称、用药疗程,患者的基础疾病、出现症状的时间、处理措施、转归情况等进行分析。结果:诱发/加重MG所涉及的29个药品品种中免疫检查点抑制药(ICB)调脂药和抗菌药物占比例较高,临床表现以眼肌型和轻中度全身型MG为主,大部分病例停用可疑药物,予乙酰胆碱酯酶抑制药、糖皮质激素、免疫抑制药等治疗后症状缓解,14.08%患者出现MG相关性死亡。结论:能够诱发/加重MG的药物品种广泛,医务人员需给予重视,对既往有MG病史的患者,需慎重选择此类药物。
Objective:To investigate the clinical characteristics of myasthenia gravis induced/exacerbated by drugs, and to provide references for the safe use of drugs in clinic. Methods:PubMed, CNKI, VIP and Wanfang Database were retrieved from January 2000 to December 2017, and the documents of MG induced/exacerbated by drugs were analyzed and discussed.The contents of the analysis included drug type, course, underlying diseases of patients, the time of symptom onset, treatments and outcomes. Results:Among the 29 drug Varieties involved, ICB, lipid-lowering drugs and antibiotics accounted for a high proportion. Ocular muscle type and mild/moderate systemic MG were mainly clinical manifestations. Most patients~, symptoms were relieved after being treated with drug withdrawal, acetylcholinesterase inhibitors, glucocorticoids, immunosuppressive agents, etc. 14.08% of patients were death because of MG. Conclusion:There were a wide variety of drugs that can induce/exacerbate MG. Medical staff should pay attention to it and carefully select these drugs for patients with a history of MG.
引文
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