非典型抗精神病药致比萨综合征文献分析

目的： 了解非典型抗精神病药致比萨综合征临床特点、治疗及转归，为安全用药提供参考。方法： 检索国内外数据库中非典型抗精神病药致比萨综合征的报道，对其临床特点进行汇总与分析。结果： 共纳入文献病例36例，涉及利培酮、氯氮平、奥氮平、喹硫平、阿立哌唑、齐拉西酮、氨磺必利、帕利哌酮8个药物品种。其中，利培酮、氯氮平、奥氮平致比萨综合征较多，分别为8，8，5例次。病例中男16例，女20例；平均年龄（38.72±18.21）岁；15例（41.66%）患者比萨综合征发生在服药后30 d内，6例（16.67%）发生在服药数年后；躯干倾斜方向19例发生在右侧，15例发生在左侧，2例未明确倾斜方向；发生比萨综合征后27例停药、6例减量、3例对症治疗，症状在2 d~2个月内均缓解或消失；药物性比萨综合征关联性评价结果显示，肯定有关的3例，很可能有关的27例，可能有关的6例。结论： 非典型抗精神病药治疗过程均可能发生比萨综合征，且与多种因素相关，临床应用时需加强监测，以减少不良反应。

Literature analysis of Pisa syndrome induced by atypical antipsychotics

OBJECTIVE To explore the clinical characteristics, treatments and outcomes of Pisa syndrome induced by atypical antipsychotics and provide references for safe medications.METHODS The reports of Pisa syndrome induced by atypical antipsychotics were retrieved from domestic and foreign databases. And their clinical characteristics were summarized.RESULTS A total of 36 cases involved 8 drug varieties including risperidone, clozapine, olanzapine, quetiapine, aripiprazole, ziprasidone, amisulpride and paliperidone. Among them, risperidone(n=8), clozapine(n=8) and olanzapine(n=5) caused Pisa syndrome respectively. There were 16 males and 20 females with an average age of(38.72±18.21) years. And 15 cases(41.66%) of Pisa syndrome occurred within 30 days after dosing and 6 cases(16.67%) several years after dosing. The tilting direction of trunk was right(n=19), left(n=15) and unclear(n=2). After an onset of Pisa syndrome, drug was discontinued(n=27) and dose-reduced(n=6) and the remainder were symptomatically treated(n=3). The symptoms abated or disappeared within 2 days to 2 months. The results of association evaluation of drug-induced Pisa syndrome hinted that association was definite(n=3), strongly related(n=27) and related(n=6).CONCLUSION Pisa syndrome may occur during the treatment course of atypical antipsychotics. It is related with multiple factors. It is necessary to strengthen monitoring clinical application to reduce the adverse reactions.