一个非常老年透析患者的塞夫特里亚脑病变
Yumiko Nakamura1, Ryo Yamamoto1, Yuya Shioda1
1Department of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
CEN case reports
|December 9, 2024
概括
塞夫特里亚克松 (CTRX) 可以导致透析患者的脑病变. 这一案例突显了肌肉和意识改变的风险,强调了在接受透析的功能衰竭患者中需要对CTRX保持谨慎.
科学领域:
- 腎臟病學 (nephrology) 是一種神經病學.
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 塞夫特里亚克松是一种常见的抗生素.
- 透析患者由于改变药理动力学而面临药物不良事件的风险.
- 塞夫特里亚克松诱导的脑病变是一种罕见但严重的并发症.
研究的目的:
- 用于描述在接受透析的患者中发生的氏脑病的病例.
- 为了强调 ceftriaxone 在这个人群中的潜在神经毒性.
- 强调在透析患者中仔细剂量和监测塞夫特里亚克森的重要性.
主要方法:
- 一个87岁的女性透析患者的病例报告.
- 临床表现,诊断工作 (MRI,CSF,EEG) 和治疗干预.
- 抗生素从塞夫特里亚克松切换到塞法索林.
主要成果:
- 患者在接受了 ceftriaxone 后出现脑病变的症状,包括不连贯的言语,不响应和肌细胞结核.
- 脑血管疾病和脑炎被MRI和CSF检查排除在外.
- 脑电图显示了前部三相波.
- 转换为塞法林导致神经症状的改善.
结论:
- 塞夫特里亚克松可以导致透析患者的脑病变和肌细胞结核,即使在功能衰竭中通常被认为是安全的.
- 在功能受损和接受透析的患者中, ceftriaxone 的肝脏分泌不排除神经毒性.
- 在透析患者中,仔细考虑塞夫特里亚克森剂量和警监测神经系统副作用至关重要.
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