89例药疹患者的致敏药物分析OA
Retrospective analysis of drug eruptions in 89 cases
目的 探讨药疹住院患者的临床特征及常见致敏药物、药疹类型,分析药疹的相关诱发因素,为临床合理用药及预防药疹的发生提供参考.方法 回顾性分析2019年4月至2023年12月底石河子大学第一附属医院确诊为药疹的患者临床数据,包括药疹类型、使用致敏药物原因、致敏药物、潜伏期、发热情况、住院时间、治疗与转归等.结果 药疹患者共89例,占皮肤科同期住院总病例的2.90%.轻症药疹63例(70.79%),以发疹型为主;重症药疹26例(29.21%),以重症多形红斑(SJS)为主.使用致敏药物原因以感染性疾病最多(44例,占49.44%).63例(70.79%)为单一药物致敏,其中前3位的致敏药物类别为抗生素类(33.33%)、中成药(26.98%)、抗癫痫药(14.29%).轻症药疹潜伏期平均(4.56±6.14)d,重症药疹潜伏期平均(9.35±11.33)d,差异有统计学意义(t=2.03,P=0.025).19.05%轻症药疹以及46.15%重症药疹患者初期并发高热.89例药疹平均住院(9.02±3.58)d,轻症药疹与重症药疹患者住院时间无统计学差异(t=3.06,P=0.05).89例患者中,有46例(51.69%)系统应用糖皮质激素,其中2例重症药疹联用丙种球蛋白治疗,2例重症药疹联用肿瘤坏死因子(TNF)-α拮抗剂.未随访到死亡病例.结论 本地区药疹类型以发疹型为主,抗生素类、中成药、抗癫痫药是前3位的致敏药物种类.多数药疹初期并发高热,尤其是重症药疹,但重症药疹与轻症药疹间住院时间无差异.早期足量应用糖皮质激素或联合治疗可缩短重症药疹的住院时间.
Objective To investigate the clinical features of drug eruptions and the most com-mon causative drugs in inpatients in order to provide a reference for the diagnosis and the treatment of drug eruptions.Methods We retrospectively analyzed the clinical data of inpatients with drug eruptions at the First Affiliated Hospital of Shihezi University from April 2019 to December 2023.Results A total of 89 inpatients with drug eruptions,accounting for 2.90%of the total inpatients at the dermatology department during the same period,included 63 cases(70.79%)of mild drug eruptions(mainly the exanthematous eruptions)and 26 cases(29.21%)of severe drug eruptions(mainly SJS).The most common condition using allergenic drugs was infectious diseases(44 cases,49.44%),while the majority of drug eruptions(63 cases,70.79%)were caused by single drug.The top 3 allergenic drugs were antibiotics(33.33%),traditional Chinese medicine(26.98%)and antiepileptics(14.29%).The latency time of mild drug eruptions was shorter than that of severe drug eruptions(4.56±6.14 days vs.9.35±11.33 days,t=2.03,P=0.025).High fever at the early stage was observed in 19.05%of patients with mild drug erup-tions and 46.15%of patients with severe drug eruptions.The mean times of hospital stay were comparable between patients with mild drug eruptions and severe drug eruptions(9.02±3.58 days).Systemic glucocorticoids were given to 46(51.69%)patients,including 4 cases of severe drug eruptions,two of each treated together with immunoglobulin and tumor necrosis factor(TNF)-αantagonist,respectively.No deaths were found during the follow-up.Conclusions Exanthema-tous eruption is the most common type of drug eruptions,while the common allergenic drugs are antibiotics,traditional Chinese medicines and antiepileptics.Large portion of patients with drug eruptions,especially severe cases,experience high fever at the early stage.However,hospitaliza-tion time does not differ between patients with severe and mild drug eruptions.Early administration of sufficient glucocorticoids alone or in combination with other therapies can shorten the hospitali-zation time for severe drug eruptions.
张亚丽;李君;梁粟;王雪;曹娟梅;贾雪松
石河子大学第一附属医院,新疆 石河子 832002石河子大学第一附属医院,新疆 石河子 832002石河子大学第一附属医院,新疆 石河子 832002石河子大学第一附属医院,新疆 石河子 832002石河子大学第一附属医院,新疆 石河子 832002石河子大学第一附属医院,新疆 石河子 832002
药疹β类酰胺类卡马西平拉莫三嗪糖皮质激素
drug eruptionβ-lactam antibioticscarbamazepinelamotrigineglu-cocorticoid
《皮肤性病诊疗学杂志》 2024 (9)
588-594,7
石河子大学第一附属医院青年基金(NQ202129)
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