药物超敏反应综合征的可疑药物及药物流行病学特征分析

目的:分析药物超敏反应综合征的可疑药物及药物流行病学特征.方法:选取35例药物超敏反应综合征,回顾性收集并分析其临床资料,寻找可疑药物并分析其流行病学特征.结果:①35例DHS关联性评价结果中,6例(17.14%)肯定(≥9分),19例(54.29%)很可能(5~8分),10例(28.57%)可能(4分).大部分DHS与可疑药物间具有较强的关联性,可疑药物有别嘌呤片(21例,60.00%),抗癫痫药(6例,17.14%),抗结核药(5例,14.29%),非甾体抗炎药(4例,11.43%);病情转归方面,91.43%(32/35)的患者经过综合治疗后,病情均显著改善并出院,8.57%(3/35)的患者因多脏器功能衰竭而死亡.大部分DHS以发热或皮疹为首发症状,其次会伴有DHS的典型临床表现,如口腔、黏膜、生殖器损害、肝肾功能损害、淋巴结肿大、肺炎等.②DHS累及最多的器官为皮肤及其附件(30.60%),其次是口眼系统(18.03%)、消化系统(13.66%)及神经系统(13.66%),血液、免疫、泌尿及呼吸系统较少累及.结论:当患者表现出高热、皮疹及内脏损害时,经普通抗感染治疗无效、且具有别嘌呤片、抗结核药、抗癫痫药等用药史,需高度警惕DHS.

Analysis of Epidemiological Characteristics of Suspected Drug and Drug Hypersensitivity Syndrome

Objective:To investigate the suspicious drugs and pharmacoepidemiologic features of drug-induced hypersensitivity syndrome ( DHS) . Methods:35 cases of drug hypersensitivity syndrome were collect-ed, clinical data were collected and analyzed retrospectively, suspicious drugs were finded and epidemiological characteristics were analyzed. Results:①Of the 35 cases of DHS association results, 6 cases (17.14%) were confirmed (≥9 points), 19 cases (54.29%) were likely (5 to 8 points), 10 cases (28.57%) were possible ( 4 points) . There was a strong correlation between most of the DHS and suspicious drugs, Suspicious drugs were purine tablets (20 cases,60.00%), antiepileptic drugs (6 cases,17.14%), anti-tuberculosis drugs (5 cases,14.29%), non-steroidal anti-inflammatory drugs (4 cases,11.43%);In terms of disease outcome, af-ter a comprehensive treatment, 91.43% (32/35) of the patients' condition were significantly improved and they all discharged, 8.57% (3/35) of patients died due to multiple organ failure. Fever or rash was the first symptom of most DHS, followed by typical clinical manifestations of DHS, such as oral, mucous membrane, genital damage, liver and kidney function damage, lymphadenopathy, pneumonia and so on. ②The most in-volved organs by DHS was the skin and its accessories (30.60%), followed by oral system (18.03%), diges-tive system (13.66%) and nervous system (13.66%), blood, immune, urinary and respiratory system less involved. Conclusion:DHS should be on the alert when the patient showed high fever, rash and visceral dam-age, the general anti-infective treatment is invalid, and they are with allopurine tablets, anti-TB drugs, an-tiepileptic drugs and other medication history.