甲氨蝶呤致药物超敏反应综合征案例报道及文献分析

摘要

目的:探讨甲氨蝶呤致药物过敏反应的临床特点,为该药的安全合理使用提供依据.方法:报道我院1例甲氨蝶呤致药物超敏反应综合征案例,并通过检索Medline,CNKI,万方、维普等数据库,收集甲氨蝶呤致过敏反应相关文献报道,进行统计分析.结果:综合文献及我院案例,共收集38例甲氨蝶呤致过敏反应病例,以18岁以下未成年患者居多,原发疾病以骨肉瘤和急性淋巴细胞白血病为主,给药方式主要为静脉滴注,临床表现多为系统性过敏症状.除3例患者死亡外,其余均症状缓解,并有5例患者经脱敏治疗后继续使用甲氨蝶呤.结论:甲氨蝶呤相关过敏反应发生率虽低但严重程度较高,临床应用时需密切关注患者的病情变化,及时采取应对措施.对发生甲氨蝶呤过敏反应又须继续用药的患者,可尝试脱敏治疗.%Objective:To investigate the clinical characteristics of methotrexate (MTX)-induced anaphylaxis.Methods:One case of MTX-induced hypersensitivity syndrome in our hospital was reported.By searching databases of Medline,CNKI,Wanfang,and VIP,relevant literatures on MTX-induced anaphylaxis were screened and analyzed.Results:A total of 38 cases of MTX-induced anaphylaxis were retrieved and analyzed,most of which were children under 18 years old.Their primary diseases were mainly osteosarcoma and acute lymphoblastic leukaemia,and intravenous dripping was the main administration route of MTX.Most cases involved systemic anaphylaxis.Except three death cases,the other patients' symptoms were alleviated,with five patients continuing MTX treatment after desensitization procedures.Conclusion:MTX-induced anaphylaxis is rare but life-threatening.Close monitoring should be carried out in patients during MTX application.Desensitization may be a safe procedure in patients who experienced MTX-induced anaphylaxis.