四联疗法根治幽门螺杆菌引发全身性药物性皮炎1例  

A case of systemic drug-induced dermatitis caused by quadruple therapy for Helicobacter pylori infection

作　　者：龚亮 李恬 禹钧博 周贵根 徐敏 张娜 GONG Liang;LI Tian;YU Junbo;ZHOU Guigen;XU Min;ZHANG Na(Health Management Center,Women&Children's Hospital of Hunan,Hunan Province,Changsha410000,China)

机构地区：[1]湖南妇女儿童医院健康管理中心,湖南长沙410000

出　　处：《中国当代医药》2023年第34期168-171,共4页China Modern Medicine

基　　金：湖南妇女儿童医院院级科研项目(金草莓项目)(FE-J202202)。

摘　　要：幽门螺杆菌(Hp)是人类常见的慢性细菌感染,在全球自然细菌感染中超过50%,是许多消化道疾病如慢性胃炎、消化性溃疡的主要致病因素。近年来一系列的研究表明,Hp感染会显著增加发生胃癌的风险。所以,根治Hp不但是治疗很多消化道疾病的前提,更是预防胃癌的重要措施。我国推荐根治Hp的一线治疗方案为四联疗法(铋剂+两种抗生素+质子泵抑制剂)和大剂量二联疗法(大剂量阿莫西林+一种质子泵抑制剂),疗程一般为14 d。目前关于四联疗法根治Hp感染引发严重全身性药物性皮炎的病例报道较少,本文报道1例患者服用四联药物根治Hp期间,出现全身性红色皮疹、水泡伴皮肤瘙痒等严重过敏反应,分析该临床表现的发生与四联药物、自身体质、用药期间饮食的相关性,为临床上根治Hp规范用药和降低药物不良反应的发生提供参考。Helicobacter pylori(Hp)is a common chronic bacterial infection in humans,accounting for more than 50%of the global natural bacterial infections.It is the main pathogenic factor for many digestive tract diseases such as chronic gastritis and peptic ulcer.A series of studies in recent years have shown that Hp infection can significantly increase the risk of gastric cancer.Therefore,the radical treatment of Hp is not only the premise of the treatment of many digestive tract diseases,but also an important measure to prevent gastric cancer.China's recommended first-line treatment for Hp is quadruple therapy(bismuth+two antibiotics+proton pump inhibitor)and high-dose dual therapy(high-dose amoxicillin+a proton pump inhibitor),the course of treatment is generally 14 days.At present,there are few reports on the cases of severe systemic drug-induced dermatitis caused by quadruple therapy in the radical treatment of Hp infection.This paper reports a case of a patient with severe allergic reactions such as systemic red rash,blisters and skin pruritus during the radical treatment of Hp with quadruple therapy,and analyzes the correlation between the occurrence of the clinical manifestations and the quadruple therapy,their own constitution and diet during the treatment.To provide reference for the clinical treatment of Hp standard drug use and reduce the occurrence of adverse drug reactions.

关 键 词：四联疗法 幽门螺杆菌 全身性药物性皮炎 病例报道 

分 类 号：R758.25[医药卫生—皮肤病学与性病学]