二巯丙磺钠致肝豆状核变性药疹48例临床分析  

Clinical analysis of 48 cases of hepatolenticular degeneration caused by dimercaptosulfonate

作　　者：孙丹丹 舒山 汪炜民 薛本春 韩永升 Sun Dandan;Shu Shan;WangWeimin;Xue Benchun;Han Yongsheng(Affiliated Hospital of Institute of Neurology,Anhui University of Traditional Chinese Medicine,Hefei City,Anhui Province,Hefei,Anhui,230061,China)

机构地区：[1]安徽中医药大学神经病学研究所附属医院神经内科

出　　处：《当代医学》2020年第4期79-83,共5页Contemporary Medicine

摘　　要：目的探讨二巯丙磺钠注射液(DMPS)在肝豆状核变性驱铜治疗中致过敏反应的临床特点、发生情况及影响因素,为该药致过敏反应的诊断、治疗和监测提供临床参考。方法对本院2018年6月至2018年12月收集的DMPS致患者过敏反应的报告进行回顾性分析,采用Microsoft Excel录入相关信息并做统计和分析。结果360例患者中出现48例药疹,过敏发生率较低,以青年患者居多;药疹类型主要有麻疹型、荨麻疹型、多形红斑型及固定型药疹,其中麻疹型药疹患者最多,为30例(62.5%);各型药疹中患者皮损部位主要以四肢为主。在前两个疗程中出现药疹反应的患者最多,为42例(87.5%);患者经抗过敏治疗后药疹症状均得到改善,转归良好。患者经脱敏治疗后,大部分患者可继续使用DMPS注射液,少数患者再次出现过敏反应。分析数据得出有无药疹史及性别与WD患者药疹的发生率均存在相关性(P<0.05),有过敏史及女性患者更易出现DMPS过敏反应;而年龄与WD患者药疹的发生率不存在相关性,差异均有统计学意义(P<0.05)。结论医护人员应在患者使用DMPS的第1和第2疗程里密切关注有无过敏反应发生。对于有过敏史患者应提示其慎重用药,可在用药前先采取一定剂量的DMPS进行预防过敏治疗或脱敏治疗。同时在临床治疗过程中护理人员要多关注女性用药情况,仔细做好相关记录,加强不良反应监测,一旦发生过敏情况及时告知医生并给予相应的抗过敏或脱敏治疗。Objective To investigate the clinical characteristics,occurrence and influencing factors of allergic reaction in the treatment of hepatolenticular degeneration by copper sulphonate injection(DMPS),and provide a clinical reference for the diagnosis,treatment and monitoring of allergic reactions induced by DMPS.Methods The reports of allergic reactions to DMPS collected in our hospital from June 2018 to December 2018 were retrospectively analyzed.Microsoft Excel was used to input relevant information and make statistics and analysis.Results The types of drug eruptions mainly include measles,urticaria,polymorphic erythema and fixed drug eruptions.Among them,measles-type drug eruptions are the most common,accounting for 30 cases(62.5%),in all types of drug eruptions,the main lesions are mainly limbs.The number of patients with drug eruption in the first two courses was the highest,with 42 cases accounting for 87.5%.After antiallergic treatment,the symptoms of drug eruption were improved and the prognosis was good.After desensitization treatment,most patients could continue to use DMPS injection,and a few patients had anaphylaxis again.Analysis of the data showed that there was a correlation between the history of drug eruption and the incidence of drug eruption in patients with WD(P<0.05).Allergic history and female patients were more likely to have DMPS allergic reactions.There was no correlation between age and the incidence of drug eruption in WD patients,and the difference was statistically significant(P<0.05).Conclusion Health care providers should pay close attention to the presence or absence of allergic reactions during the first and second courses of DMPS.For patients with a history of allergies,they should be prompted to use the drug carefully,and a certain dose of DMPS can be taken before the medication to prevent allergy treatment or desensitization treatment.At the same time,in the course of clinical treatment,nursing staff should pay more attention to the situation of female medication,carefully record

关 键 词：二巯丙磺钠注射液 肝豆状核变性 药疹 抗过敏治疗 脱敏治疗 

分 类 号：R758.25[医药卫生—皮肤病学与性病学]