124例药源性中毒性表皮坏死松解症不良反应病例分析  

Analysis of 124 cases of drug-induced toxic epidermal necrolysis

作　　者：郭俊荣 刘曼 王旭红[1] GUO Jun-rong;LIU Man;WANG Xu-hong(Department of Clinical Pharmacy,Beijing Luhe Hospital Affiliated to the Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京潞河医院临床药理科,北京101149

出　　处：《中国药物应用与监测》2020年第5期329-332,共4页Chinese Journal of Drug Application and Monitoring

基　　金：北京市科技计划课题(Z171100001017071)。

摘　　要：目的:对引起中毒性表皮坏死松解症的药物进行总结,分析药物致敏原因,为临床安全合理用药提供参考。方法:通过检索PubMed、CNKI、万方、维普数据库,对引起药源性中毒性表皮坏死松解症的药品名称、患者性别及年龄分布、不良反应发生时间、治疗方法及转归等情况进行统计分析。结果:共计纳入符合标准文献120篇,涉及患者124例,致敏药物主要为抗生素、抗癫痫药物、解热镇痛抗炎药、抗痛风药物等,其中卡马西平、甲氨蝶呤、别嘌醇发生药品不良反应(ADR)例次较高。ADR主要发生在7 d以内(68例,54.8%),多伴有肝肾功能损害。大部分患者经积极对症治疗转归良好,死亡患者22例。结论:应关注中毒性表皮坏死松解症的致敏药物,建议采用SCORTEN评分对患者进行预后评估,必要时对患者进行基因检测,将用药风险降到最低。Objective:To summarize drugs involved in drug-induced toxic epidermal necrolysis,analyze the causes of drug sensitization,and provide references for rational drug use.Methods:Data of literature about drug-induced toxic epidermal necrolysis retrieved from PubMed,CNKI,Wanfang,VIP databases were analyzed in terms of drug names,the gender and age distribution of patients,occurrence time of adverse drug reaction(ADR),treatment,outcomes,etc.Results:A total of 120 literature were enrolled in this study,124 patients were involved.Drugs that caused drug-induced toxic epidermal necrolysis mainly were antibiotics,antiepileptic drugs,antipyretic analgesic and anti-gout drugs,in which carbamazepine,methotrexate,allopurinol were the most.ADR mainly occurred within 7 days(68 cases,54.8%)after administration and most of them were accompanied by liver and kidney damage.Most patients had good outcomes after actively systematic treatment while 22 patients died.Conclusion:Drugs that could cause toxic epidermal necrolysis should be paid more attentions to.It was recommended to use the SCORTEN score to evaluate the prognosis of patients with drug-induced toxic epidermal necrolysis.If necessary,gene test should be carried out to minimize the risk of medication.

关 键 词：中毒性表皮坏死松解症 药品不良反应 文献分析 

分 类 号：R969.3[医药卫生—药理学]