抗癫痫药物引起重型药疹33例临床分析

目的探讨抗癫痫药物（AEDs）引起重型药疹（SDE）的发病机制、临床表现、治疗和防预措施。方法回顾性研究了四川大学华西医院在1999年12月～2005年11月收治住院的药疹患者1265例,筛选出由抗癫痫药物（AEDs）引起重型药疹（SDE）患者33例临床资料。结果33例重型药疹（SDE）患者致敏药物为卡马西平（CBZ）占63.64%;重症多形性红斑（SEM）发生率为69.7%;并发药物性肝损害为63.64%。结论引起重型药疹的抗癫痫药物（AEDs）以卡马西平（CBZ）最常见,且以重症多形性红斑（SEM）发生率最高;并发药物性肝损害最常见。及时停用致敏药物,尽早使用糖皮质激素,大剂量免疫球蛋白冲击治疗能迅速控制病情,且无明显不良反应。

Clinical analysis on 33 patients with severe drug eruption caused by antiepileptic drugs

Objective To explore the pathogenesis, clinical feature, and treatment prevention of severe drug eruption （SDE） ,which caused by anfiepileptic drugs（AEDs）. Methods A retrospective clinical analasis was made in 1265 inpatients with drug eruption from December 1999 to November 2005 ,From those patients we chose 33 eases of severe drug eruption,which caused by anfiepileptic drugs（AEDs）. Results Among 33 patients with severe drug eruption（SDE） ,63.64% was caused by cabamarzepine, Incidence of severe erythema muhiforma（SEM） was 63.64%. hepatitis caused by drugs was 63.64% in many complications. Conclusion Among severe drug eruption（SDE） caused by antiepileptie drugs （AEDs） ,cabamarzepine was the most common, And incidence of severe erythema multiforma （SEM）was the highest. Hepatitis medieamentosa was the most common in many complications. So we must stop the allergenic drugs as quickly as we can. Early using corticosteroids and high-dose intravenous immunoglohulins in the treatment of severe drug eruptions can suppress progression. The two ways were not apparently ad verse reactions.