实例探讨药物引起SJS或TEN的评分方法--Naranjo评分与ALDEN评分比较

摘要

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) induced by drugs are severe cutaneous adverse reactions, characterized by extensive detachment of epidermis and erosion of mucous membranes. In addition to the long term adopted Naranjo score to assess the causality of adverse drug reactions, ALDEN score derived from two large-scale case-control study also proved to be a useful assessment tool to evaluate the causality of drug-induced epidermal necrolysis recently. We described ALDEN score in detail and compared the assessment results of both tools applied through a real TEN case resulted in coadministrating acetaminophen and cefradine in this paper, and discussed the differentiation and suitability of two scores.%药物引起的史蒂文斯-约翰逊综合征（SJS）和中毒性表皮坏死松解症（TEN）是一种罕见严重的不良反应，其特征是广泛性的皮肤表皮剥离和黏膜侵犯。当评估可疑药物和SJS或TEN之间的因果关系时，除了Naranjo评分外，最近根据两个大型的病例对照研究结果所衍生的ALDEN评分也提供了新思路。本文结合1例同时服用对乙酰氨基酚和头孢拉定导致中毒性表皮坏死综合征的案例，应用ALDEN评分及Naranjo评分分析两种药物与ADR间的关联性，并讨论此两种评分方法的差异性及适宜性。