华西医院住院患者“青霉素过敏史”相关问卷调查  

Questionnaire survey of inpatients with label of past history of“penicillin allergy”in West China Hospital

作　　者：蒋子涵 肖浩[1] 孟娟[1] JIANG Zi-han;XIAO Hao;MENG Juan(Allergy Center of Otolaryngology,Head and Neck Surgery Department,West China Hospital,Sichuan University,Chengdu 610041)

机构地区：[1]四川大学华西医院耳鼻咽喉头颈外科过敏反应中心,成都610041

出　　处：《中华临床免疫和变态反应杂志》2022年第6期589-594,共6页Chinese Journal of Allergy & Clinical Immunology

基　　金：四川大学华西医院学科卓越发展1·3·5工程临床研究孵化项目(2018HXFH026);成都市科技局技术创新研发项目(2021-YF05-00473-SN)。

摘　　要：目的了解国内住院患者“青霉素过敏史”相关情况。方法从四川大学华西医院数据库中调取一年内的住院患者数据,筛选出过敏史中有“青霉素过敏史”记录的患者,从中再以完全随机抽样法抽取1000例患者,对其进行电话问卷调查。结果有“青霉素过敏史”的患者共5691例,占一年内住院患者总数的4.00%,占有“药物过敏史”患者的44.25%。653例“青霉素过敏”患者完成了调查。在291例(44.56%)单纯依据既往给药前常规皮试结果阳性而诉过敏的患者中,240例因既往一次皮试阳性就被诊断“青霉素过敏”;51例曾进行过多次皮试,其中24例皮试结果为“有时阴性,有时阳性”。308例(47.17%)因使用药物后出现不适症状诉过敏:153例(49.68%)为速发型反应,125例(40.58%)仅累及皮肤系统,137例(44.48%)累及两个及以上系统,60例(19.48%)累及皮肤系统及其他系统。结论“青霉素过敏史”是住院患者“药物过敏史”中最常见的类别。“青霉素过敏史”一半基于既往给药前常规皮试阳性,一半基于既往使用青霉素类药物出现不适症状。本研究结果可为国内青霉素过敏规范化临床诊断体系的建立提供基础和依据。Objective To investigate the status of hospital patients with label of penicillin allergy in China.Methods The electronic health records were reviewed from database of inpatients in West China Hospital of Sichuan University within a whole year and patients with label of penicillin allergy were screened out,basing on records of allergy history.1000 patients were selected using complete random sampling method among them and then a telephone questionnaire survey were conducted.Results A total of 5691 patients was labeled as“penicillin allergy”,around 4.00%of inpatients within the whole year and 44.25%of patients with label of drug allergy respectively.653 patients with label of“penicillin allergy”finished the telephone interview.291 patients(44.56%)were labeled as“penicillin allergy”only due to positive results of routine skin test before administration of penicillin.Among them,240 patients were prescribed skin test only one time and were diagnosed as“penicillin allergy”due to positive result,while another 51 patients were prescribed skin test more than one time,but skin tests results of 24 patients were inconsistent.308 patients(47.17%)were labeled as“penicillin allergy”due to uncomfortable symptoms during administration of penicillin.153(49.68%)patients were attacked by immediate reactions.Symptoms of 125(40.58%)patients were restricted to cutaneous system.Two or more than two systems were involved among 137(44.48%)patients,while both cutaneous and another systems were involved among 60(19.48%)patients.Conclusions“Penicillin allergy”is the most prevalent“drug allergy”among hospitalized patients.Half of them are labeled“penicillin allergy”because of positive results of routine skin test before administration,while another half due to adverse events after administration.Results of our study could provide basis and evidence for the necessity of establishment of standardized algorithm for diagnosis of penicillin allergy.

关 键 词：青霉素 药物过敏 过敏反应 

分 类 号：R593.1[医药卫生—内科学]