目的 系統(tǒng)分析奧司他韋致精神異常的臨床特點(diǎn)，為臨床實(shí)踐提供證據(jù)和建議。方法 計(jì)算機(jī)檢索PubMed、Embase、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)、中國(guó)知網(wǎng)、維普數(shù)據(jù)庫(kù)和萬(wàn)方數(shù)據(jù)庫(kù)，時(shí)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(bào)道，對(duì)文獻(xiàn)進(jìn)行篩選、數(shù)據(jù)歸納及統(tǒng)計(jì)。結(jié)果 最終納入中英文文獻(xiàn)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(wú)基礎(chǔ)疾病，68.2%的患者為聯(lián)合用藥，所有患者均無(wú)精神相關(guān)疾病史。不良反應(yīng)表現(xiàn)為失眠、情緒異常、行為異常、幻覺(jué)、譫妄，嚴(yán)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(yīng)癥狀，時(shí)間最長(zhǎng)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(yīng)嚴(yán)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(yīng)改善時(shí)間超過(guò)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(yīng)關(guān)聯(lián)性評(píng)價(jià)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(jiàn)的不良反應(yīng)，多表現(xiàn)為情緒異常、行為異常、幻覺(jué)、譫妄等，一般在用藥2 d內(nèi)發(fā)生，臨床醫(yī)生和藥師應(yīng)當(dāng)主動(dòng)告知患者及家屬，發(fā)現(xiàn)精神異?，F(xiàn)象應(yīng)立即停藥，及時(shí)就醫(yī)，避免導(dǎo)致嚴(yán)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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