药物超敏反应综合征35例临床分析  

Clinical analysis of 35 cases of drug-induced hypersensitivity syndrome

作　　者：陈秀芳 梁愉笳 屠纯海 陈盼 谢健平 肖嵘[2] 张桂英[2] 湛意[2] Chen Xiufang;Liang Yujia;Tu Chunhai;Chen Pan;Xie Jianping;Xiao Kong;Zhang Guiying;Zhan Yi(Department of Dermatology and Venereology,Changsha Central Hospital,Changsha 410007,China;Department of Dermatology and Venereology,the Second Xiangya Hospital of Central South University,Changsha 410011,China)

机构地区：[1]长沙市中心医院皮肤性病科,410007 [2]中南大学湘雅二医院皮肤性病科,长沙410011

出　　处：《中国医师杂志》2020年第10期1478-1482,共5页Journal of Chinese Physician

基　　金：国家自然科学基金(81500187,81502710)。

摘　　要：目的通过分析药物超敏反应综合征的临床特点.提高对药物超敏反应综合征的诊断和治疗的认识。方法选取2014年1月1日至2019年12月31日中南大学湘雅二医院皮肤科收治的35例药物超敏反应综合征患者进行临床分析总结。结果35例患者中,引起或可能引起药物超敏反应综合征的药物有10类,致病药物中以抗生素最多见,其次为别嘌呤醇、抗癫痫药、非甾体抗炎药。临床表现主要为皮疹、发热、淋巴结肿大.嗜酸性粒细胞明显增高、肝功能损害等。皮疹表现多样,65.71%(23/35)的患者表现为发疹样皮疹。主要治疗方法为系统使用糖皮质激素及免疫球蛋白,必要时可联合免疫抑制剂和血液灌流。结论如患者有明确的用药史,出现皮疹、高热、淋巴结肿大,检查结果出现嗜酸性粒细胞、转氨酶升高等,应高度怀疑药物超敏反应综合征,早期诊断及治疗预后较好。Objective To investigate the clinical features of drug induced hypersensitivity syndrome(DiHS)and enhance the recognition of is diagnosis and treatment.Methods Drug indued hypersensitivity syndrome diagnosed in the Sccond Xiangya Hospital of Central South University in recent 6 years were retrospectively analyzed and summarized.Results Of 35 cases of drug-induced hypersensitivity syndrome there were ten types of suspected drugs.Antibiotics were the most common allergy-inducing drug,followed by allopurinol,antiepileptics,and non-steroidal anti inlammalory drugs.The expected clinical findings of DiHS were characterized by skin rash,fever,enlarged lymph nodes,which may be accompanied by eosinophilia,liver function damaged.The lesions of DiHS were variable and the majority of cases 65.71%(23/35)were characterized by eruptive papules.The main therapeutic approach of DiHS was systemic application of glucocorticoids and intravenous immunoglobulin(IVIG).When necessary its combination with immunosuppressant or hemoperfusion(HP).Conclusions DiHS should be on the high alert when a patient with medication history,rash,high fever and lymph nodes large,accompanied by eosinophil-ia,liver function damaged.Predictors of good prognosis are early diagnosis and treatment.

关 键 词：嗜酸粒细胞增多 药物超敏反应综合征 皮疹 糖皮质激素类 

分 类 号：R758.25[医药卫生—皮肤病学与性病学]