CAJ | 학술논문

目的探讨喹诺酮类抗生素诱发重症肌无力症状加重的临床特点.方法总结2008年7月至2011年6月北京友谊医院神经内科收治随访的9例应月喹诺酮类抗生素导致症状加重的重症肌无力患者的临床资料.对9例患者的性别、年龄、加重前分型、临床绝对评分、伴随疾病、诱发疾病、所用抗生素、使用抗生素后加重时间/症状及加重程度、治疗措施及治疗1个月时预后等进行回顾性分析.结果环丙沙星(n=4)、左氧氟沙星(n=1)、盐酸莫西沙星(n=4)均有可能使重症肌无力症状加重,用药后加重时间为15 min至4d不等,QMG评分平均增加10分,主要表现为呼吸困难、复视、眼睑下垂及吞咽困难,停药并加用对症治疗,临床预后较好.结论喹诺酮类药物能够加重重症肌无力患者的临床症状,需要临床医生警惕.
목적 탐토규낙동류항생소유발중증기무력증상가중적림상특점.방법 총결2008년7월지2011년6월북경우의의원신경내과수치수방적9례응월규낙동류항생소도치증상가중적중증기무력환자적림상자료.대9례환자적성별、년령、가중전분형、림상절대평분、반수질병、유발질병、소용항생소、사용항생소후가중시간/증상급가중정도、치료조시급치료1개월시예후등진행회고성분석.결과 배병사성(n=4)、좌양불사성(n=1)、염산막서사성(n=4)균유가능사중증기무력증상가중,용약후가중시간위15 min지4d불등,QMG평분평균증가10분,주요표현위호흡곤난、복시、안검하수급탄인곤난,정약병가용대증치료,림상예후교호.결론 규낙동류약물능구가중중증기무력환자적림상증상,수요림상의생경척.
Objective To explore the characteristics of acu(r)e exacerbations of myasthenia gravis after fluoroquinolone exposure.Methods Gender,age,prior type,absolute score,concurrent disease,precipitated disease,use of antibiotic,ouset/symptom/degree of exacerbation,therapeutic measures and prognosis at Month 1 were retrospectively analyzed for 9 patients after fluoroquinolone systemic exposure.Results Ciprofloxacin (n =4),levofloxacin (n =1) and moxifloxacin (n =4) exposure resulted in myasthenia gravis exacerbation.Myasthenia gravis exacerbations developed at 15 minutes to 4 days postexposure.And the clinical scores of quantitative myasthenia gravis (QMG) increased by an average of 10.The main syndromes included dyspnea,diplopia,ptosis and dysphagia.All patients improved upon the withdrawal of fluoroquinolone in conjunctions with other interventions.Conclusion Fluoroquinolone exposure may result in myasthenia gravis exacerbations in patients with underlying diseases.Healthcare professionals should be aware of this serious drug-disease association.