非甾体抗炎药致重症药疹文献汇总分析  

Literature analysis of non-steroidal anti-inflammatory drugs induced severe drug eruptions

作　　者：罗兴献 刘一[1] 薛学财[1,2] 陈月 王宇航[1] 杨长青[2] 冯婉玉 

机构地区：[1]北京大学人民医院药剂科,北京100044 [2]中国药科大学基础医学与临床药学学院,江苏南京211198

出　　处：《中国医院药学杂志》2017年第21期2155-2159,共5页Chinese Journal of Hospital Pharmacy

摘　　要：目的:以临床实例出发探讨非甾体抗炎药致重症药疹的特点和关联性,为临床用药安全提供参考。方法:通过检索1970-2017年国内外期刊数据库公开报道的非甾体抗炎药致重症药疹的病例,提取文献中患者年龄、性别、致ADR药物、重症药疹类型等信息进行统计和分析。结果:非甾体抗炎药致重症药疹文献49篇,共计病例49例。其中单一用药致重症药疹病例有27例,联合用药22例;49例非甾体抗炎药致重症药疹中发生率最高为对乙酰氨基酚,其次为吡罗昔康、布洛芬、依托考昔;非甾体抗炎药致重症药疹平均潜伏期为(7.88±10.42)d,其中致药物超敏反应综合征潜伏期最长,可长达(36.50±14.20)d;大部分患者停药后好转,1例因中毒性表皮坏死松解征死亡。结论:非甾体抗炎药致重症药疹具有潜在的危险性,临床应用时应提高警惕,以减少重症药疹给患者带来的危害。OBJECTIVE To analyze the clinical characteristics and relevance of severe drug eruptions induced by non-steroidal anti-inflammatory drugs （NSAIDs）, and to supply information for clinical application. METHODS Relevant literatures reported in domestic and foreign journals from 1970 to 2017 were collected and statistically analyzed. Data were extracted including age, sex, drugs possibly inducing adverse drug reactions （ADRs）, types of severe drug eruptions and so on. RESULTS Relevant literatures were retrieved and 49 patients were involved. In these patients, 27 ADRs were induced by single non-steroidal anti-inflammatory drug, 22 by combined medication. Of 49 NSAIDs induced severe drug eruptions, the top four drugs were acetaminophen, piroxicam, ibuprofen and etoricoxib. The average latency of severe drug eruption was 7.88±10.42 d, and hypersensitivity syndrome induced by NSAIDs had the longest latency of 36.50±14.20 d. Most of the cases were relieved after drug withdrawn except one patient died due to toxic epidermal necrolysis. CONCLUSION These findings suggest clinicians to monitor patient skin symptoms seriously, to reduce the occurrence of severe drug eruptions.

关 键 词：非甾体抗炎药 重症药疹 不良反应 安全用药 

分 类 号：R969[医药卫生—药理学]