住院药疹患者临床特征及分析

摘要

Objective To understand the clinical characteristics of hospitalized patients with drug eruption induced and sensitive drug types.Methods Totally 91 cases with drug eruption were enrolled.Allergic drugs,medication causes,administration,latency,drug rash clinical classification,clinical manifestation,treatment and prognosis were analyzed.Results Female (64 cases,70.3％) and above 60 years old (32 cases,35.2％) were related to drug allergy; most allergic drugs were with oral administration [78.0％ (71/91)],severe drug eruption latency,mucosal involvement,heating rate,infection,hepatic and renal function damage,the course of treatment were higher than those of severe drug eruption [5(3,16)d vs 4(1,8) d,42.9％ (6/14) vs 5.2％(4/77),85.7％ (12/14) vs 9.1％ (7/77),92.9％ (13/14) vs 80.5％ (62/77),57.1％ (8/14) vs 45.5 ％ (35/77),35.7％ (5/14) vs 19.5 ％ (15/77),(13.3 ± 9.3) d vs (7.8 ± 3.7) d].The allergenic agents mainly included antibiotics[39.6％ (39/91)],non-steroid [15.4％ (14/91)],antipyretic and analgesic agents [13.2％ (12/91)],anti gout agents [5.5 ％ (5/91)],antiepileptics (GFDA2) [4.4％ (4/91)] ; types of drug eruption consists of severe drug eruption[15.4％ (14/91)],non severe drug eruption[84.6％ (77/91)] ; exanthematous [26.4％ (24/91)],erythema multiforme [26.4％ (24/91)] and urticaria [22.0％ (20/91)].Conclusion Antibiotics are the main causes of drug eruption.Antiepileptic agents,anti gout agents and antibiotics are the main allergic agents.%目的 了解本院住院药疹患者的致敏药物种类和临床特点.方法 回顾性分析2009年1月至2013年12月于上海市虹口区江湾医院住院确诊的91例药疹患者的一般情况、致敏药物、用药原因、用药方式、潜伏期、药疹的临床分型、临床表现、治疗和转归等方面资料.结果 91例药疹患者中女性64例,占70.3％;60岁以上老年人32例,占35.2％.过敏药物以口服剂型[78.0％ (71/91)]为主.重症药疹潜伏期、黏膜受累、发热率、并发感染、肝肾功能损害、疗程均大于非重症药疹[5(3,16)d比4(1,8)d、42.9％(6/14)比5.2％ (4/77)、85.7％ (12/14)比9.1％ (7/77)、92.9％ (13/14)比80.5％(62/77)、57.1％ (8/14)比45.5％(35/77)、35.7％ (5/14)比19.5％ (15/77)、(13.3±9.3)d比(7.8±3.7)d];药疹致敏药物主要构成为抗菌药物[39.6％ (39/91)],非甾体类[15.4％(14/91)],解热镇痛类[13.2％(12/91)],抗痛风类[5.5％(5/91)],抗癫痫类[4.4％(4/91)];药疹疹型构成为重症药疹[15.4％(14/91)],非重症药疹[84.6％ (77/91)];其中以发疹型[26.4％ (24/91)]、多形红斑型[26.4％ (24/91)]、荨麻疹型[22.0％(20/91)]为主.结论 抗菌药物是药疹的主要致敏药物,抗癫痫药、抗痛风药、抗菌药是重症药疹主要致敏药物;对入院患者开展药学监护有利于提高临床药物治疗水平.