氟喹诺酮类抗菌药物致过敏性休克137例临床特点及相关因素分析  

Analysis of clinical characteristics and correlation factors of fluoroquinolone-induced anaphylactic shock in 137 cases

作　　者：吴小玲[1] 章志红[1] 平静[1] 

机构地区：[1]南昌大学抚州医学分院,江西抚州344000

出　　处：《中国医院药学杂志》2015年第2期144-147,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的：探讨氟喹诺酮类抗菌药物致过敏性休克的临床特点及相关因素,为临床安全用药提供参考。方法：对2005—2012年国内公开报道的137例喹诺酮类抗菌药所致过敏性休克进行统计分析。结果：137例休克患者中,年龄分布以21~50岁之间较多,占总数的62.8%。过敏性休克速发型（发生在30 min之内）的占66.4%,迟发型过敏性休克占33.6%。比较休克时几种意识状态、舒张压与恢复时间关系,发现本组休克患者恢复时间与意识状态无统计学意义,但与舒张压的高低有关。舒张压越低,恢复时间越长（R=-0.435,P=0.000）。几组治疗药与休克恢复时间关系,用等级相关分析得出：R=0.441,P=0.000,表明恢复时间与使用药物种类呈正比,即联合用药越多,恢复时间越长。＂肾上腺素（adrenaline,AD）＋地塞米松（dexamethasone,DXM）等四联＂组与＂AD＋DXM＂组比较,前者恢复时间明显长于后者（t=3.825,P=0.000）。分析休克时舒张压高低与治疗药的关系,发现舒张压越低,使用＂AD＋DXM等四联＂越多（R=-0.357,P=0.000）。结论：氟喹诺酮类抗菌药致过敏性休克在国内已不再罕见,且迟发型比例较高,应警惕。休克一旦发生,应正确诊断和治疗。对于血压极低的过敏性休克患者,宜尽早使用AD＋DXM等多药和积极采取其他急救措施。OBJECTIVE To discuss the characteristics and correlation factors of fluoroquinolone-induced anaphylactic shock,and provide reference for safe clinical drug use.METHODS The clinical data of shock induced by fluoroquinolone in 137 cases publicly reported in China from2005 to 2012 were statistically analyzed.RESULTS In 137 cases with shock,the patient age was mostly distributed between 21 and 50 years,accounted for 66.0%.Patients with immediate anaphylactic shock（occurred within 30 min）accounted for 66.4%,and delayed type accounted for 33.6%.Correlation of consciousness state and diastolic pressure with recovery time was compared,and it was found that the recovery time was not correlated with consciousness state,but with diastolic blood pressure.The lower the diastolic pressure,the longer the recovery time（R=-0.435,P=0.000）.Relationship between several groups of drugs and recovery time was obtained by the rank correlation analysis：R=0.441,P=0.000,suggesting that the recovery time was positively related to drug types,i.e.,more drugs combined would result in longer recovery time.Compared to＂AD＋DXM＂combination,＂adrenaline（AD）＋ dexamethasone（DXM）quadruple＂group had significantly longer recovery time（t=3.825,P=0.000）.Comparison of diastolic pressure and therapeutic drugs showed that,more use of＂AD ＋ DXM quadruple＂more would result in lower diastolic pressure（R=-0.357,P=0.000）.CONCLUSION Fluoroquinolone-induced anaphylactic shock is not rare in China,in which the delayed type has a higher proportion.Once the shock occurs,it should be correctly diagnosed and treated.For patients with anaphylactic shock with extremely low blood pressure,you should use AD ＋ DXM and other emergency measures as soon as possible.

关 键 词：氟喹诺酮类抗菌药 过敏性休克 临床特点 因素 

分 类 号：R978[医药卫生—药品]