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本文报导一例由于在肺结核的治疗中使用利福平(RFP)而引起急性器质性脑部综合症.男性,64岁.确诊为“肺结核”入院.入院前每天用异烟肼(INH)550毫克、乙胺丁醇(EMB)1800毫克、链霉素(SM)1克、维生素B_650毫克.住院后继续用INH、Vit B_6治疗,停用其他药物,改用RFP600mg/日,以后改为300mg/日.住院第42天,病人出现语言、定向障碍、情绪激动不安,且渐加重,出现了幻觉,此时曾复查患者血液,未见异常.体检发现膝反射亢进、鼻—眉反射阳性、双侧踝阵挛.脑脊液正常、颅骨摄片亦未见异常,CT提示有轻度脑皮质萎缩,无局灶性损害,脑电图提示双侧弥漫性慢波.诊断为“器质性脑部综合症”.
This article reports an example of acute organic brain syndrome caused by the use of rifampicin (RFP) in the treatment of tuberculosis. The male, 64 years old, was diagnosed with “pulmonary tuberculosis.” Admissions to isoniazid (INH ) 550mg, ethambutol (EMB) 1800mg, streptomycin (SM) 1g, vitamin B_650mg. After hospital stay with INH, Vit B_6 treatment, disable the other drugs, switch to RFP600mg / day, after the change Was 300mg / day .In hospital the first 42 days, the patient appeared language, disorientation, emotional agitation, and gradually increased, there was hallucinations, at this time the patient’s blood was reviewed, no abnormalities found knee reflex examination, nasal - eyebrow reflex Positive, bilateral ankle clonus, normal cerebrospinal fluid, skull radiography were also normal, CT showed mild cortical atrophy, no focal lesion, EEG showed bilateral diffuse slow wave. Qualitative brain syndrome ".