他汀类药物致过敏反应分析

目的:探讨他汀类药物致过敏反应发生的特点和规律,为临床合理用药提供参考。方法:选取2015年1月至2021年3月该院不良反应监测网上报的他汀类药物致过敏反应病例,同时检索2000年1月至2021年3月中国知网、万方数据库和维普数据库收录的他汀类药物致过敏反应文献,对病例进行统计分析。结果:该院上报他汀类药物致过敏反应4例,检索文献获得他汀类药物致过敏反应的个案报道26篇(26例),共30例;其中男性患者19例(占63.33%),女性患者11例(占36.67%);患者年龄为32~85岁,平均年龄为61.4岁;过敏反应发生时间最短为口服后5 min,最长为连续口服6个月,其中17例(占56.67%)发生于用药后≤3 d;过敏反应包括皮肤过敏(19例)、过敏性休克(3例)、血管神经性水肿(5例)、药物热(2例)和过敏性哮喘(1例);5例(占16.67%)报告了更换其他调节血脂药替代治疗方案。结论:他汀类药物可导致休克、血管神经性水肿和过敏性哮喘等过敏反应,用药时应注意患者的用药监护,特别是首次用药初期;出现不良反应,应及时上报;对于应用他汀类药物利大于弊的患者,应阐明发生过敏反应时的替代治疗方案,为临床用药提供参考。

Allergic Reactions Induced by Statins

OBJECTIVE:To probe into the characteristics and regularities of the occurrence of allergic reactions induced by statins,so as to provide reference for clinical rational drug application.METHODS:Cases of allergic reactions induced by statins reported on the adverse dug reaction monitoring network in this hospital from Jan.2015 to Mar.2021 were selected,and literature related to allergic reactions induced by statins from Jan.2000 to Mar.2021 were retrieved from CNKI,Wanfang Data and VIP database,and the cases were statistically analyzed.RESULTS:There were 4 cases of allergic reactions induced by statins reported in this hospital,and 26 case reports(26 cases)of allergic reactions induced by statins were retrieved from the literature search,with a total of 30 cases;among them,19 cases(63.33%)were male and 11 cases(36.67%)were female;the ages of patients ranged from 32 to 85 years old,with a mean age of 61.4 years old;the shortest time of allergic reactions was 5 minutes after oral administration,and the longest time was 6 months after continuous oral administration,of which 17 cases(56.67%)occurred≤3 d after drug administration;allergic reactions included skin allergy(19 cases),allergic shock(3 cases),angioneurotic edema(5 cases),drug fever(2 cases),and allergic asthma(1 case);5 cases(16.67%)reported changing to other lipid-regulating drugs as an alternative treatment regimen.CONCLUSIONS:Statins can lead to allergic reactions such as shock,angioneurotic edema and allergic asthma,so that attention to patient’s medication monitoring during administration should be paid,especially at the initial stage of first administration;and adverse reactions should be reported promptly;for patients whose benefits from statins outweigh the disadvantages,alternative treatment regimens of allergic reactions should be clarified to provide reference for clinical medication.