药源性过敏性休克和严重过敏样反应报告分析  

Case analysis of drug- induced anaphylactic shock and anaphylactoid reaction

作　　者：马翔[1] 李潇潇[1] 刘维[1] 张婷[1] 翟所迪[1] 

机构地区：[1]北京大学第三医院药剂科,北京100191

出　　处：《中国临床药理学杂志》2015年第19期1964-1967,共4页The Chinese Journal of Clinical Pharmacology

基　　金：卫生部临床重点专科建设项目(56495-04)

摘　　要：目的了解北京大学第三医院药源性过敏性休克(DIAS)和严重过敏样反应(DIAR)的致敏药物类型及过敏反应的发生情况(包括临床表现、救治方案及预后等)。方法筛选北京大学第三医院2004-01-01—2014-12-31上报国家药品不良反应监测系统的DIAS和DIAR报告,对纳入报告患者的一般情况、致敏药物类型、临床表现、治疗方案及转归等资料进行分析。结果共纳入69份不良反应报告,男女比例为1.00∶1.56,以速发型超敏反应为主(85.5%),最常见的致敏药物为抗菌药物(45.5%),临床症状主要表现为心血管系统(92.8%)、呼吸系统(58.0%)和皮肤黏膜系统(58.0%)受累。在DIAS和DIAR救治中,糖皮质激素(58.0%)、补液治疗(53.6%)以及抗过敏药物治疗(40.6%)最为常见。69份不良反应报告中,经救治后痊愈29例(42.0%),好转37例(53.6%),死亡、住院治疗、数据缺失各1例(1.4%)。结论 DIAS与DIAR占全部报告的2.5%(69/2761),由于其存在不可预测性,对患者危害较大,建立规范的救治及预防措施具有重要意义。Objective To understand the situation of drug- induced anaphylactic shock（ DIAS） and severe anaphylactoid reaction（ DIAR）in Peking university third hospital,including allergenic drug categories,clinical manifestations,treatments and prognosis. Methods Reports of DIAS and DIAR were selected from reports submitted by Peking University Third Hospital to National adverse drug reaction monitoring system from Jan 1st,2004 to Dec 31 st,2014. The general information,allergenic drug categories,clinical manifestations,treatments and prognosis were analyzed. Results A total of 69 reports were entered. Of them,there were larger proportion of female population（ male vs female =1. 00∶ 1. 56） and immediate reactions（ 85. 5%）. Antibiotics（ 45. 5%）are drugs most frequently causing anaphylactic shocks and severe anaphylactoid reactions. The clinical manifestations include symptoms of cardiovascular system（ 92. 8%）, respiratory system（ 58. 0%） and skin / mucous membrane system（ 58. 0%）. Glucocorticoids（ 58. 0%）,fluid support（ 53. 6%） and antiallergic medications（ 40. 6%） are the most common choices in the treatment. The outcomes include29（ 42. 0%） events of recovery,37（ 53. 6%） events of improvement,1（ 1. 4%） event of death, 1（ 1. 4%） event of hospitalization and1（ 1. 4%） missing data among all of 69 events. Conclusion Reports of DIAS and DIAR accounts for 2. 50%（ 69 /2761） of the total reports.Forming a standard procedure of emergent treatment is of great importance because of the unpredictable and fatal characteristics of DIAS and DIAR.

关 键 词：药源性急性严重过敏反应 药源性过敏性休克 药源性严重过敏样反应 

分 类 号：R969.2[医药卫生—药理学] R969.3[医药卫生—药学]