巴克洛芬增强了透析失衡综合征中的神经功能障碍
Junjing Guo1, Latif Salam1, Kwesi Blackman2
1Medicine, SUNY Downstate Health Science University, New York, USA.
Cureus
|January 13, 2026
概括
透析失衡综合征 (DDS) 可能发生在接受巴克洛芬治疗的末期病 (ESRD) 患者中. 剩余的巴克洛芬可能会降低BUN减少值,在血液透析 (HD) 期间引起DDS症状.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 神经科学是一个神经科学.
- 临床毒理学 临床毒理学
背景情况:
- 透析失衡综合征 (DDS) 是血液透析 (HD) 的神经并发症,由透液转移引起.
- 巴克洛芬是一种GABA模拟剂,用于和打. 巴克洛芬的神经毒性会导致中枢神经系统的抑郁,特别是在末期病 (ESRD) 患者中.
研究的目的:
- 报告ESRD患者治疗巴克洛芬并接受首次HD的脑病变病例.
- 为了调查巴克洛芬和透析之间的潜在神经毒理学相互作用.
主要方法:
- 一个68岁的ESRD男性的案例研究,用巴克洛芬治疗尿液性打.
- 患者在停止服用巴克洛芬后接受了两次低血流率的HD疗程.
- 临床表现和血液尿素 (BUN) 水平在HD之前和之后被监测.
主要成果:
- 在HD之后,患者出现了惰,混乱和动荡,与DDS一致,尽管BUN减少低于典型值.
- 扣留HD导致BUN增加,并在72小时内恢复到基线心理状态.
- 这些发现表明,在较低的BUN减少水平下,残留的巴克洛芬增强了DDS.
结论:
- 在接受巴克洛芬治疗的ESRD患者中,药物残留水平可能会降低DDS的BUN降低值.
- 在这种情况下,应将HD参数 (长度,流量) 标化为BUN水平,以达到每日BUN清除值≤20 mg/dL.
- 建议在接受巴克洛芬治疗的患者进行透析的谨慎管理,以防止神经毒性相互作用.
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