目的 系統(tǒng)分析奧司他韋致精神異常的臨床特點，為臨床實踐提供證據(jù)和建議。方法 計算機檢索PubMed、Embase、中國生物醫(yī)學文獻數(shù)據(jù)庫、中國知網(wǎng)、維普數(shù)據(jù)庫和萬方數(shù)據(jù)庫，時間截止到2021年1月，納入奧司他韋致神經(jīng)精神不良事件的中英文病例報道，對文獻進行篩選、數(shù)據(jù)歸納及統(tǒng)計。結(jié)果 最終納入中英文文獻19篇，22例患者（男10例，女12例）。中位年齡17歲，其中50%為18歲以下兒童。多數(shù)患者無基礎疾病，68.2%的患者為聯(lián)合用藥，所有患者均無精神相關疾病史。不良反應表現(xiàn)為失眠、情緒異常、行為異常、幻覺、譫妄，嚴重者可出現(xiàn)自殺現(xiàn)象。68.2%的患者在服藥2 d內(nèi)出現(xiàn)不良反應癥狀，時間最長在服藥4 d后出現(xiàn)癥狀。主要的治療措施是立即停藥，7例不良反應嚴重者使用抗精神病藥物（主要為苯二氮類），多數(shù)患者在停藥2 d內(nèi)癥狀均有所改善或消失，其中3例患者不良反應改善時間超過10 d，中位累積藥量450 mg，最大累積藥量750 mg，最小累積藥量60 mg。不良反應關聯(lián)性評價為肯定1例，很可能18例，可能3例。結(jié)論 神經(jīng)精神事件是奧司他韋少見的不良反應，多表現(xiàn)為情緒異常、行為異常、幻覺、譫妄等，一般在用藥2 d內(nèi)發(fā)生，臨床醫(yī)生和藥師應當主動告知患者及家屬，發(fā)現(xiàn)精神異?，F(xiàn)象應立即停藥，及時就醫(yī)，避免導致嚴重后果。

Objective Systematic review and analysis the clinical characteristics of oseltamivir induced mental disorders to provide evidence and suggestions for clinical practice. Methods The PubMed, Embase, CBM, CNKI, VIP and WANFANG as databases were searched by computer. Until December 2020, both Chinese and English case reports of oseltamivir neuropsychiatric adverse events were included. Two researchers independently screened the literatures, summarized and statistically analyzed the data. Results A total of 19 literatures in Chinese and English were searched, including 22 patients (10 males and 12 females). The median age was 17, and 50% of them were children under 18 years of age. Most of the patients had no underlying diseases, 68.2% of the patients were given combined medication, and all the patients had no history of mental diseases. Adverse drug reaction performance is insomnia, abnormal mood, abnormal behavior, hallucination, delirium, serious person can appear suicide phenomenon. 68.2% of the patients developed adverse drug reaction symptoms within 2 days after taking the drug, and the longest time was 4 days after taking the drug. The main treatment was immediate discontinuation of drugs. Seven patients with severe adverse drug reaction were treated with antipsychotic drugs (mainly benzodiazepines). The symptoms of most patients improved or disappeared within 2 days after discontinuation of drugs, among which the adverse drug reaction improvement time of 3 patients was over 10 days. The median cumulative dose was 450 mg, the maximum cumulative dose was 750 mg, and the minimum cumulative dose was 60 mg. Adverse drug reaction correlation evaluation was positive in 1 case, big probable in 18 cases, and probable in 3 cases. Conclusion Neuropsychiatric events are rare adverse reactions of oseltamivir, mainly manifested as emotional abnormalities, behavioral abnormalities, hallucinations, delirium, etc., which generally occur within 2 days after administration of oseltamivir. Clinicians and pharmacists should take the initiative to inform the patients and their family members, and should immediately stop medication and seek medical advice when mental abnormalities are found to avoid serious consequences.

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