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目的探讨抗精神病药物致恶性综合征的临床特征,以提高对综合征的认识,降低误诊率及病死率。方法回顾性分析1例抗精神病药物致恶性综合征患者的临床资料并检索、复习相关文献。结果该例患者长期服用氯丙嗪、碳酸锂、氯氮平等抗精神病药物,疗效不佳,入院时肌注氟哌啶醇、加服阿立哌唑5 d后出现高热、意识障碍、四肢肌张力高、进食困难及自主神经功能紊乱,排除性诊断后予以综合治疗有效,患者病情逐渐好转。结论恶性综合征是抗精神病药物所致严重不良反应,在临床上较为罕见,病死率可高达20%~30%,尽早诊断及早期治疗同时,应注意防治横纹肌溶解症等并发症。
Objective To investigate the clinical features of antipsychotic-induced malignant syndrome in order to improve the understanding of the syndrome and reduce the misdiagnosis rate and mortality rate. Methods The clinical data of one patient with malignant syndrome induced by antipsychotics were retrospectively analyzed and retrieved. The related literatures were reviewed. Results The long-term use of chlorpromazine, lithium carbonate, clozapine and other antipsychotic drugs, poor efficacy, admission haloperidol, plus aripiprazole 5 d after the emergence of fever, unconsciousness, limb muscle High tension, eating difficulties and autonomic dysfunction, to be comprehensive treatment of exclusion diagnosis effective, the patient’s condition gradually improved. Conclusions Malignant syndrome is a serious adverse reaction caused by antipsychotics. It is rare in clinic. The mortality rate can reach as high as 20% ~ 30%. As soon as possible, early diagnosis and early treatment should pay attention to the prevention and treatment of complications such as rhabdomyolysis.