长期局部外用高浓度糖皮质激素制剂的不良反应调查  

Investigation on the Adverse Reactions of Long-term Topical High-concentration Glucocorticoid Preparations

作　　者：杨晓宇 李如意[1] YANG Xiaoyu;LI Ruyi(Department of Dermatology,Fuxin Central Hospital,Fuxin 123000,Liaoning,China)

机构地区：[1]阜新市中心医院皮肤科,辽宁阜新123000

出　　处：《中国药物滥用防治杂志》2021年第4期524-527,共4页Chinese Journal of Drug Abuse Prevention and Treatment

摘　　要：目的:探讨长期局部外用高浓度糖皮质激素制剂的不良反应,为临床合理用药提供参考。方法:回顾性分析该院2017年3月-2021年3月收治的120例患者长期局部外用高浓度糖皮质激素制剂的病例资料,分析长期局部外用高浓度糖皮质激素制剂的不良反应。结果:分析120例患者的用药史,使用糖皮质激素注射类制剂中地塞米松磷酸钠占比最高,其次是甲泼尼龙琥珀酸钠、氢化泼尼松注射液;主要治疗的疾病类型为肺部感染、慢性肾功能衰竭(CRF)、慢性阻塞性肺疾病(COPD)等。最常见的不良反应为皮肤萎缩、水肿、咳嗽、皮肤菲薄、痤疮等。女性比男性长期局部外用高浓度糖皮质激素制剂出现不良反应的危险程度要大;与20~50岁的患者相比,<20岁与20~30岁的患者出现不良反应的危险程度高,且20~30岁的患者出现不良反应的危险程度要高于<20岁的患者;文化程度方面,小学及以下、初中患者出现不良反应的危险程度要高于高中以上学历的患者;入组后患者糖皮质激素制剂使用的平均浓度方面,91~100 mg/(kg·d)的不良反应危险程度高于71~90 mg/(kg·d)的不良反应危险程度,二者危险程度均高于60~70 mg/(kg·d)。痊愈率方面,120例患者中痊愈95例,占79.2%;好转25例,占20.8%,病例报告无严重后遗症及死亡。结论:小于60 mg/(kg·d)的治疗效果较好,但长期高浓度[>60 mg/(kg·d)]局部外用糖皮质激素制剂的不良反应较多,应该加强对糖皮质激素制剂的管理,从而减少不良反应的发生。Objective: To explore the adverse effects of long-term topical high-concentration glucocorticoid preparations, and provide references for clinical rational use of drugs. Methods: To retrospectively analyze the case data of 120 patients admitted to the hospital from March 2017 to March 2021 of long-term topical high-concentration glucocorticoid preparations, and analyzed the adverse reactions of long-term topical high-concentration glucocorticoid preparations. Results: Analyzing the medication history of 120 patients, dexamethasone sodium phosphate accounted for the highest proportion of glucocorticoid injection preparations, followed by methylprednisolone sodium succinate and prednisone injection;the main type of disease treated was pulmonary infection, Chronic Renal Failure(CRF), Chronic Obstructive Pulmonary Disease(COPD), etc. The most common adverse reactions are skin atrophy, edema, cough, thin skin, and acne. Women are at greater risk of adverse reactions than men with long-term topical high-concentration glucocorticoid preparations;compared with patients aged 20-50 years, patients younger than 20 years and 20-30 years old are at higher risk of adverse reactions, and The risk of adverse reactions in patients between 20 and 30 years old is higher than that of patients under 20 years of age;in terms of education level, the risk of adverse reactions in patients with elementary school and below and junior high school is higher than that of patients with high school education or above;patients after enrollment In terms of the average concentration of glucocorticoid preparations, the risk of adverse reactions of 91-100 mg/(kg·d) is higher than that of 71-90 mg/(kg·d), and the risks of both are higher than 60 ~ 70 mg/(kg·d). In terms of recovery rate, 95 of the 120 patients recovered, accounting for 79. 2%;25 cases improved, accounting for 20. 8%, and no serious sequelae or death were reported. Conclusion: The therapeutic effect of less than 60 mg/(kg·d) is better, but long-term high-concentration [ > 60 mg/(k

关 键 词：长期 局部 外用 高浓度 糖皮质激素制剂 不良反应 

分 类 号：R969[医药卫生—药理学]