45例药物致急性泛发性发疹性脓疱病特征分析  

Clinical Characteristics of 45 Cases of Patients with Drug-induced Acute Generalized Exanthematous Pustulosis

作　　者：周娜[1,2] 高婷婷 周小勇[2] 覃莉[2] 陈柳青[2] ZHOU Na;GAO Tingting;ZHOU Xiaoyong;QIN Li;CHEN Liuqing(Jianghan University,Wuhan 430056,China;Department of Dermatology,Wuhan No.1 Hospital,Wuhan 430022,China)

机构地区：[1]江汉大学,武汉430056 [2]武汉市第一医院皮肤科,武汉430022

出　　处：《医药导报》2023年第2期268-270,共3页Herald of Medicine

摘　　要：目的分析药物致急性泛发性发疹性脓疱病(AGEP)情况,为临床诊治及预防提供循证医学证据。方法回顾性分析2012年1月—2020年12月武汉市第一医院皮肤科收治的AGEP住院患者的临床资料,分析诱发因素、临床表现和特点、治疗及其转归。结果45例AGEP住院患者,男24例,女21例,45例患者发病前有明确用药史,AGEP潜伏期0.5~10 d。其中23例(51.11%)出现发热,1~5 d体温恢复正常。4例(8.89%)出现黏膜损害,未见系统受累。28例(62.22%)白细胞升高,37例(82.22%)C反应蛋白升高,7例(15.56%)出现嗜酸性粒细胞升高。经过系统或局部糖皮质激素治疗后,患者痊愈。结论AGEP患者发病的主要诱发因素是使用抗菌药物,其中最常见为β-内酰胺类,临床治疗原则为立即停用可疑致敏药物。AGEP外用强效糖皮质激素或系统使用小至中等剂量糖皮质激素,病情均可得到有效控制。Objective To study on the acute generalized exanthematous pustulosis(AGEP)caused by drugs,and to provide evidence-based medical evidence for guiding future clinical diagnosis,prevention,and treatment.Methods The clinical data of 45 hospitalized patients with AGEP admitted to the Department of Dermatology of Wuhan First Hospital from January 2012 to December 2020 were retrospectively analyzed,the predisposing factors,clinical manifestations and characteristics,treatment and outcomes of AGEP were analyzed.Results A total of 45 AGEP inpatients with 24 males and 21 females had a history of medication before the onset of the disease,and the incubation period of AGEP was 0.5-10 days.Among them,23 patients(51.11%)developed fever,and body temperature returned to normal in 1-5 days.And 4 patients(8.89%)had mucosal damage,and none of them had systemic damage.Twenty-eight patients(62.22%)had elevated leukocytes,and 37 patients(82.22%)had elevated C-reactive protein,and 7 patients(15.56%)had elevated eosinophils.After the systemic or topical corticosteroid therapy,rashes completely subsided and condition recovered.Conclusion Systematic use of antibiotics is the main predisposing factor for AGEP in our hospital,of which the most common used antibiotics isβ-lactams.The disease can be effectively controlled by immediate withdrawal of suspected drugs.Topical potent glucocorticoids or systemic use of small to moderate doses of glucocorticoids can effectively control the AGEP.

关 键 词：药品不良反应 急性泛发性发疹性脓疱病 药疹 

分 类 号：R969.3[医药卫生—药理学] R751[医药卫生—药学]