重症药疹74例临床分析

发布时间：2018-04-19 20:22

本文选题：药疹 + 回顾性研究　；参考：《中华临床医师杂志(电子版)》2012年14期

【摘要】：目的探讨重症药疹的发生规律、临床特点和治疗措施。方法对1998～2011年我科收治的74例重症药疹患者的临床资料进行回顾性分析。结果重症药疹以重症多形红斑型药疹(SJS)多见,占48.6%(36/74)。别嘌呤醇在致敏药物中居首位,占21.6%(16/74),其次是卡马西平,占18.9%(14/74)。别嘌呤醇的潜伏期最长,且肝肾损害率高,分别为87.5%和50.0%。四种类型中SJS与中毒性表皮坏死松解型药疹(TEN)的黏膜损害率均为100%,药物超敏反应综合征(DRESS)的黏膜损害率最小为28.6%。DRESS的发病年龄比剥脱性皮炎型药疹(ED)小,DRESS的潜伏期较TEN与SJS长。TEN的日最大糖皮质激素用量平均值为4.13mg/kg,均高于其他三组,其住院时间较SJS长,平均为23.09d。TEN的并发症为85.7%,高于其他三组,死亡率高。结论致敏药物的种类、药疹类型与病情的严重程度密切相关,别嘌呤醇与卡马西平应用需谨慎,激素联合免疫球蛋白(IVIG)治疗有效。
[Abstract]:Objective to investigate the occurrence, clinical characteristics and treatment of severe drug eruption. Methods the clinical data of 74 patients with severe drug eruption from 1998 to 2011 were analyzed retrospectively. Results severe drug eruption was more common in severe erythema erythema SJS( 48.6%) than in 36% (74%). Allopurinol was the first in allopurinol sensitizers, accounting for 21.6C / 74, followed by carbamazepine (18.9c14 / 74). The latent period of allopurinol was the longest and the rate of liver and kidney damage was 87.5% and 50.0% respectively. The mucosal damage rate of SJS and toxic epidermal necrosis release drug eruption (TEN) was 100. The lowest rate of mucosal damage in drug hypersensitivity syndrome (DRESS) was that the onset age of 28.6%.DRESS was lower than that of EDD. The latency of DRESS was lower than that of DRESS. The average daily maximum glucocorticoid dosage of TEN and SJS was 4.13 mg / kg, which was higher than that of the other three groups. The length of hospitalization was longer than that of SJS, and the average complication of 23.09d.TEN was 85.7, which was higher than that of the other three groups, and the mortality rate was higher. Conclusion Allopurinol and carbamazepine should be used with caution and the combination of hormone and immunoglobulin IVIGis is effective in the treatment of allopurinol and carbamazepine.
【作者单位】：安徽医科大学附属省立医院皮肤科;
【分类号】：R758.25

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