重症药疹的临床特征、致敏药物及预后相关因素的回顾性分析

目的 探讨重症药疹患者的临床特征、致敏药物及预后相关因素。方法 回顾性分析湖州市第一人民医院2013年3～8月收治的23例重症药疹患者临床资料，包括重症药疹的主要发病类型及致敏药物。同时根据发病类型及致敏药物将患者分组，总结不同发病类型及致敏药物的临床治疗效果，并对预后的相关因素进行分析。结果 23例患者中重症多形红斑型药疹患者15例（65．21％），青霉素类及头孢菌素类致敏9例（39．14％）为发病最高类型及致敏药物。不同发病类型及不同致敏药物的患者治疗效果比较，差异无统计学意义（P〉0．05）。年龄、接受治疗时间、内脏受累程度、血常规白细胞、空腹血糖、白蛋白、谷草转氨酶（AST）、谷丙转氨酶（ALT）均是预后的影响因素（P〈0．05）。结论 重症药疹以重症多形红斑型药疹为主，且青霉素类及头孢菌素类为主要致敏药物，年龄、接受治疗时间、内脏受累程度、血常规白细胞、空腹血糖、白蛋白、AST、ALT均与预后相关。

Retrospective analysis of clinical features,sensitization drugs and prognosis related factors of severe drug eruption

Objective To study the clinical features, sensitization drugs and prognosis related factors of patients with severe drug eruption. Methods The clinical data of 23 patients with severe drug eruption in the First People＇s Hospital of Huzhou City from March to August 2013 were retrospectively analyzed, including main disease types and sensitization drugs. At the same time the patients were divided into different groups respectively according to the disease types and sensitization drugs, and their clinical therapeutic effects were summarized. Factors associated with prognosis were analyzed. Results Among 23 patients with severe drug eruption, 15 cases （65.21%） had severe erythema muhiforme type drug eruption, 9 patients （39.14%） had sensitization induced by Penicillin and Cephalosporin, they were the highest incidence of disease types and sensitization drugs. The treatment effect of patients with different disease types and sensitization drugs had no statistically significant difference （P 〉 0.05）. Age, treatment time, the degree of visceral involvement, routine blood leukocytes, fasting glucose, albumin, aspertate aminotransferase （AST）, alanine aminotransferase （ALT） were the factors associated with prognosis （P 〈 0.05）. Conclusion Severe erythema muhiforme type drug eruption is the primary type of severe drug eruption, and Penicillin and Cephalosporin are the main sensitization drugs. Age, treatment time, the degree of visceral involvement, routine blood leukoeytes, fasting glucose, albumin, AST, ALT are related to prognosis.