重症药疹52例治疗分析  

Clinical Analysis of the Treatment With High-dose Intravenous Immunoglobulin and Glucocorticoid on 52 Cases of Severe Drug Eruption

作　　者：邓伟平[1] 黄跃深[1] 万建绩[1] 丁街生[1] 王群[1] 

机构地区：[1]广东省人民医院皮肤科,广东广州510080

出　　处：《中国皮肤性病学杂志》2006年第12期740-741,共2页The Chinese Journal of Dermatovenereology

摘　　要：目的探讨大剂量静脉注射免疫球蛋白(HD-IVIG)联合糖皮质激素治疗重症多形红斑型药疹、中毒性表皮坏死松解型药疹、剥脱性皮炎型药疹的临床疗效和副作用。方法应用HD-IVIG0.4g/(kg.d),静滴,连续5天为1个疗程,并联合糖皮质激素治疗重症药疹52例。结果HD-IVIG联合糖皮质激素治疗重症多形红斑型药疹、中毒性表皮坏死松解型药疹、剥脱性皮炎型药疹的药物热有较好临床疗效,退热时间分别为(1.26±3.78)天,(3.26±1.65)天,(2.28±2.35)天;皮疹开始收敛时间分别为(2.37±2.55)天,(1.46±0.58)天,(4.34±3.18)天;住院时间分别为(22.57±12.19)天,(12.14±10.29)天和(36.96±24.26)天;HD-IVIG的副作用发生率仅11.54%(6/52),均为轻微反应;治疗中未发生严重的副作用。结论HD-IVIG联合糖皮质激素方案是治疗重症药疹的有效选择之一,并具有较好的安全性。Objective To study the clinical therapeutic effect and adverse effect of treatment with high-dose intravenous immunoglobulin （HD-IVIG） and glucocorticoid on severe drug eruption （erythema multiforme major;toxic epidermal necrolysis;exfoliative dermatitis） . Methods 52 cases of severe drug eruption were treated by HD-IVIG （ 0.4g/（ kg · d） for 5 days every course of treatment,intravenous injections） and glucocorticoid. Results There were better clinical therapeutic effect to treat drug fever of severe drug eruption cases （erythema multiforme major;toxic epidermal necrolysis; exfoliative dermatitis） with high-dose intravenous immunoglobulin （HD-IVIG） and glucocorticoid, The fever-declining time was 1.26 ± 3.78d ,3.26±1.65d, 2. 28 ± 2.35d respectively. Astfinging time of eruption was 2.37 ±2.55 d, 1.46 ± 0. 58 d,4.34 ± 3.18 d respectively, Length of stay was 22.57 ± 12, 19 d, 12.14 ± 10.29 d ,36.96 ± 24.26 d respectively. Incidence rate of HD - WIG adverse effects was only 11.54% （ 6/52 ） and slight. There was no severe adverse effect in the course of treatment. Conclusion The program of HD-IVIG and glucocorticoid to treat severe drug eruption was one of the effective choices and there was better safety.

关 键 词：免疫球蛋白 重症药疹 多形红斑 中毒性表皮坏死松解 剥脱性皮炎 

分 类 号：R758.25[医药卫生—皮肤病学与性病学]