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1例83岁男性患者因患慢性阻塞性肺病、肺源性心脏病合并感染,给予环丙沙星400 mg,1次/d静滴;甲泼尼龙40 mg,2次/d静滴。第2天患者出现烦躁不安,情绪亢奋。停用环丙沙星,甲泼尼龙剂量减为40 mg,1次/d后患者精神状态稍有好转。第6天,患者再次出现精神行为异常,有被害妄想和自残行为。排除肺性脑病和茶碱中毒,考虑甲泼尼龙可能与精神障碍相关,停用甲泼尼龙,改口服泼尼松,患者精神症状逐渐好转。
One 83-year-old man with chronic obstructive pulmonary disease and pulmonary heart disease complicated with infection was given ciprofloxacin 400 mg once daily and intravenous methylprednisolone 40 mg twice daily. Day 2 patients with irritability, emotional excitement. Ciprofloxacin withdrawal, methylprednisolone dose was reduced to 40 mg, 1 times / d, slightly improved mental status. On the 6th day, the patient again showed abnormal mental behavior, delusional victimization and self-mutilation. To rule out pulmonary encephalopathy and theophylline poisoning, consider methylprednisolone may be related to mental disorders, disable methylprednisolone, change oral prednisone, the patient’s psychiatric symptoms gradually improved.