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126例重症药疹住院患者的临床特征及预后 预览 被引量:3

Clinical characteristics and prognosis for 126 patients with severe drug eruption
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摘要 目的:探讨各型重症药疹的临床特点、常见致敏药物及治疗,为重症药疹的合理防治、减少其并发症、提高治愈率提供参考。方法:对中南大学湘雅医院2009年6月至2017年5月收治的126例重症药疹的临床资料进行回顾性分析。结果:126例重症药疹中,男女比例为1:1.38;住院时间为(12.7±9.8)d。最常见类型为重症多形红斑型药疹,最凶险的类型为大疱性表皮松解型药疹,死亡2例。抗生素为本组患者最常见的致敏药物类别;最常见的单一致敏药物为卡马西平,其次为别嘌呤醇。结论:本地区重症药疹多见于中青年人群,重症多形红斑型药疹为最常见类型,大疱性表皮松解型药疹病死率最高,药物超敏反应综合征的住院时间最长。及时停用致敏药物,早期足量应用糖皮质激素,适时联合使用非激素治疗手段如静脉注射免疫球蛋白(intravenous immunogloblin,IVIG)、血浆置换、血液透析,有助于提高疗效,降低并发症和病死率。 Objective: To explore the clinical characteristics of various types of severe drug eruption and common sensitized drugs, and to provide clinical references for reducing the incidence of severe drug eruption.Methods:The clinical data regarding 126 cases of severe drug eruption were analyzed retrospectively from June 2009 to May 2017 in Xiangya Hospital,Central South University.Results:In the 126 cases of severe drug eruption,the distribution of men and women ratio was 1:1.38.The length of stay was(12.7±9.8)d.The most common type was Steven-Johnson syndrome;the most dangerous type was drug-induced bullosa epidermolysis.The most common sensitized drug category in these patients was antibiotics;the most common single sensitizing drug was carbamazepine,following by allopurinol.Conclusion:Severe drug eruption occurs mostly in young and middle-aged people.StevenJohnson syndrome is the most common type;drug hypersensitive syndrome has the longest length of hospital course.Mortality rate of drug-induced bullosa epidermolysis is the highest.Timely stop using of allergens,early using glucocorticoids,and timely combination of non-glucocorticoids treatment(such as intravenous immunogloblin,plasma exchange and hemodialysis),can improve the efficacy and reduce the complications and mortality.
作者 李捷 毛曼云 唐妮 翟睿 朱武 易梅 陈明亮 LI Jie, MAO Manyun, TANG Ni, ZHAI Rui, ZHU Wu, YI Mei, CHEN Mingliang (Department of Dermatology, Xiangya Hospital, Central South University, Changsha 410008, China)
出处 《中南大学学报:医学版》 CSCD 北大核心 2017年第8期953-957,共5页 Journal of Central South University (Medical Sciences) Journal of Central South University (Medical Sciences)
基金 国家自然科学基金(81673065) 湖南省自然科学基金(2016JJ3170) 湖南省科技计划项目(2014SK3108)
关键词 重症药疹 临床特征 预后 抗生素 卡马西平 别嘌呤醇 severe drug eruption clinical characteristics prognosis antimicrobials carbamazepine allopurinol
作者简介 李捷,Email:xylijie@medmail.com.cn 通信作者(Corresponding author):陈明亮,Email:chenmingliang6S@aliyun.com
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