严重的efavirenz相关的神经毒性:一个回顾性队列研究
Priyadarshini Arnab1, Roland Croxford2, Janet Scott2
1Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Southern African journal of infectious diseases
|October 2, 2023
概括
埃法维伦兹 (EFV) 神经毒性,包括严重的症状,如动力衰竭和精神运动减缓,与更高的药物度和异化暴露有关. 停止使用EFV通常会消除这些不良影响.
科学领域:
- 药理学 药理学是指药理学的学科.
- 神经科学是一个神经科学.
- 临床医学 临床医学
背景情况:
- 埃法维伦兹 (EFV) 经常与神经精神症状有关.
- EFV引起的严重神经毒性已有证据,但其临床表现和风险因素需要进一步定义.
研究的目的:
- 描述EFV相关神经毒性的临床表现,风险因素和结果.
- 帮助临床医生更早地识别严重的神经毒性.
主要方法:
- 在南非开普敦,对具有超治疗性EFV度 (> 4 mg/L) 的成年患者进行了回顾性分析.
- 从医疗记录中提取临床和实验室数据.
- 后勤回归以确定与神经精神病症状和严重神经毒性的关联.
主要成果:
- 包括81名患者;62人经历神经精神表现 (无氧,精神运动减缓),19人患有肝毒性.
- 神经精神症状与更长的EFV治疗持续时间,更高的EFV度和同时暴露于异化有关.
- 在47名患者中发生严重的神经毒性,在停止EFV治疗后,76%的患者的症状消失.
结论:
- 对于EFV引起的严重神经毒性存在度-效应关系.
- 严重的神经毒性往往表现为晚期,但在停止使用EFV后可逆.
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