摘要
目的促进亚甲蓝的临床安全使用。方法检索中国生物医学文献数据库、维普中文科技期刊数据库、中国知网、万方医学数据库及PubMed、Embase数据库收载的亚甲蓝致血清素综合征个案报道相关文献,检索时限为各数据库自建库起至2023年5月。提取患者的性别、年龄、用药指征、用药剂量、合并用药、临床表现、干预措施、恢复及转归等信息,并进行描述性统计分析。结果共纳入24篇文献,涉及患者24例。患者中,男女各半;年龄(23篇文献提及)15~77岁,平均(55.30±15.67)岁。用药指征主要为外科手术诊断(19例,79.17%);多采用静脉滴注给药(21例,剂量1~2 mg/kg、5~10 mg/kg、50~100 mg/kg或425 mg);联用血清素类药物以抗抑郁药居多(19例,79.17%);血清素综合征发生时间以麻醉苏醒后居多(9例,37.50%),症状以肢体障碍多见(20例,83.33%);转归以好转多见(22例,91.67%),中位好转时间2 d。结论亚甲蓝致血清素综合征罕见但严重,多发于中老年患者,联用多种血清素药物时会加大该不良反应的发生风险。患者联用亚甲蓝及其他血清素类药物时应密切监测临床症状。
Objective To promote the clinical safe use of methylene blue.Methods The case reports related to serotonin syndrome induced by methylene blue in the CBM,VIP,CNKI,WanFang Med Online,PubMed and Embase databases from the inception of each database to May 2023 were searched.The information on patients′gender,age,medication indications,dosage,combined medication,clinical manifestations,intervention measure,recovery and outcome was extracted for descriptive statistical analysis.Results A total of 24 reports were included;24 patients were involved,including 12 males and 12 females,and their age was in the range of 15-77 years in 23 reports,with an average of(55.30±15.67)years.The main medication indication was surgical diagnosis(19 cases,79.17%).The patients were given drugs mainly by intravenous drip with a dosage of 1-2 mg/kg,5-10 mg/kg,50-100 mg/kg or 425 mg(21 cases).The serotonin drugs were often used in combination with antidepressants(19 cases,79.17%).The serotonin syndrome mostly occurred after anesthesia awakening(nine cases,37.50%),and symptoms were more common in limb disorders(20 cases,83.33%).The most common outcome was improvement(22 cases,91.67%),with a median improvement-time of 2 d.Conclusion The serotonin syndrome induced by methylene blue is rare but serious,which often occurs in middle-aged and elderly patients.The risk of this adverse reaction will increase when multiple serotonin drugs are used in combination.When methylene blue is used in combination with other serotonin drugs,the clinical symptoms of patients should be closely monitored.
作者
黄星尧
贺盛发
黄光明
HUANG Xingyao;HE Shengfa;HUANG Guangming(The First People's Hospital of Fangchenggang,Fangchenggang,Guangxi,China 538021;The First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi,China 530021)
出处
《中国药业》
CAS
2024年第20期I0001-I0005,共5页
China Pharmaceuticals
关键词
亚甲蓝
血清素综合征
血清素毒性
个案报道
文献分析
用药安全
methylene blue
serotonin syndrome
serotonin toxicity
case report
literature analysis
medication safety
作者简介
第一作者:黄星尧,男,大学本科,副主任药师,研究方向为药源性不良反应,(电子信箱)63966554@qq.com;通信作者:黄光明,男,硕士研究生,副主任药师,研究方向为药品不良反应数据挖掘及处理,(电子信箱)513080380@qq.com。
