抗结核药物引起药物超敏反应综合征病例分析  

Analysis of A Case of Drug Hypersensitivity Syndrome Induced by anti-Tuberculosis Drugs

作　　者：蒋晓磊[1] 朱玉莲 李靖 钱梦茹 崔小娇 董丽娥 杨勇 JIANG Xiaolei;ZHU Yulian;LI Jing;QIAN Mengru;CUI Xiaojiao;DONG Lie;YANG Yong(Department of Pharmacy,Gansu Provincial Hospital of TCM,Gansu Province,Lanzhou 730050,China;Department of Pharmacy,the People's Hospital of Ziyang City,Sichuan Province,Ziyang 641300,China;Department of Pharmacy,Sichuan Academy of Medical Science&Sichuan Provincial People's Hospital,School of Medicine,University of Electronic Science and Technology of China,Sichuan Povince,Chengdu 610072,China;Department of Pharmacy,Western Theater General Hospital,Chengdu 610072,China)

机构地区：[1]甘肃省中医院药学部,兰州730050 [2]四川省资阳市人民医院药学部,资阳641300 [3]四川省医学科学院·四川省人民医院药学部·电子科技大学药学院,成都610072 [4]西部战区总医院药学部,成都610072

出　　处：《医药导报》2021年第8期1116-1120,共5页Herald of Medicine

基　　金：2020年四川省卫建委医学重大创新项目(20ZDCX002)。

摘　　要：目的提高抗结核药物引起药物超敏反应综合征(DIHS)的诊治水平。方法回顾1例抗结核药物所致DIHS患者的病情变化,结合DIHS专家共识和相关文献对患者的临床症状、检验指标及处置进行分析。结果患者出现持续发热、迟发性皮疹、多处淋巴结肿大,血液学异常、肝脏受损、病情反复等特点符合DIHS诊断标准。结论及时停用所有抗结核药物是关键,轻症患者使用抗过敏药物对症治疗即可,重症患者可采用糖皮质激素、免疫球蛋白冲击治疗,但目前尚无统一共识,应权衡利弊使用。Objective To provide empirical reference for the clinical diagnosis and treatment of drug hypersensitivity syndrome(DIHS)induced by anti-tuberculosis drugs.Methods A case of DIHS caused by anti-tuberculosis drugs was reviewed,and combined with the expert consensus of DIHS and relevant literature,the clinical symptoms,laboratory indicators,and the treatment of the patient were analyzed.Results The patient presented a persistent fever,delayed rash,multiple enlarged lymph nodes,hematological abnormality,liver injury,and relapse,which met the diagnostic criteria of DIHS.Conclusion Timely discontinuation of anti-tuberculosis drugs is the key.Mild patients can use anti-allergic drugs for the symptomatic treatment,and severe patients can use glucocorticoid and immunoglobulin impulse therapy.Hormone treatment may cause the spread of tuberculosis,but there is no consensus.Thus,we should weigh the advantages and disadvantages.

关 键 词：抗结核药 超敏反应综合征 药品不良反应 病例报告 

分 类 号：R978.3[医药卫生—药品]