奥卡西平致Stevens-Johnson综合征和中毒性表皮坏死松解症的特点及基因相关性分析

发布时间：2018-03-20 16:40

本文选题：奥卡西平　切入点：Stevens-Johnson综合征　出处：《中国药房》2017年05期 　论文类型：期刊论文

【摘要】：目的:探讨奥卡西平致Stevens-Johnson综合征(SJS)和中毒性表皮坏死松解症(TEN)的临床特点及其基因多态性。方法:计算机检索中国知网(CNKI)、万方、维普、PubMed、EMBase、SpringerLink等数据库,对有关奥卡西平引起严重皮肤不良反应的个案报道文献进行整理和分析。结果:收集文献12篇,获取奥卡西平引发SJS/TEN的病例报道13例。奥卡西平的严重皮肤不良反应发生于男性多于女性,不良反应大多发生在用药后1~14 d,经过糖皮质激素、抗过敏药物等治疗均能痊愈,没有致死性病例报道。8例患者进行了基因型检测,其中6例患者为HLA-B*1502阳性,2例为HLA-B*1518/B*4001(HLA-B*1502的变异)。结论:应当严密监测奥卡西平的不良反应,注意患者用药教育与随访,必要情况下通过检测HLA-B*1502基因可指导临床合理使用奥卡西平,优化临床用药方案。
[Abstract]:Objective: to investigate the clinical features and gene polymorphisms of Stevens-Johnson syndrome (SJSS) and toxic epidermal necrolysis (TEN) induced by oxcarbazepine. The case reports of severe skin adverse reactions caused by oxcarbazepine were reviewed and analyzed. Results: 12 articles were collected. A total of 13 cases of SJS/TEN caused by oxcarbazepine were reported. The severe skin adverse reactions of oxcarbazepine occurred in more men than in women, and most of the adverse reactions occurred at 1 to 14 days after treatment, and were cured by glucocorticoids and antiallergic drugs. No fatal cases were reported in which genotypes were detected in 8 patients, of whom 6 were HLA-B*1502 positive and 2 were HLA-B*1518/B*4001(HLA-B*1502 variants. Conclusion: the adverse reactions of oxcarbazepine should be closely monitored, drug education and follow-up should be paid attention to. If necessary, the detection of HLA-B*1502 gene can guide the rational use of oxcarbazepine and optimize the clinical regimen.
【作者单位】：华中科技大学同济医学院附属协和医院药学部;武汉市新洲区人民医院药学部;
【基金】：国家科技支撑计划子课题(No.2013BAI06B04)
【分类号】：R758.59

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