CAJ | 학술논문

目的分析药物超敏反应综合征(DHS)的临床特点.方法回顾性分析北京协和医院2011年1月至2014年2月住院患者中确诊的10例DHS病例资料,归纳其临床特点,总结DHS的发病规律.结果 10例患者中男4例,女6例.发病年龄17 ～66岁.可疑致敏药物分别为抗惊厥药5例,别嘌呤醇2例,抗生素1例,对乙酰氨基酚1例,不详1例.10例患者均于用药后14 ～60 d出现皮疹伴发热,6例出现淋巴结肿大.皮疹中以麻疹样皮疹最常见(6例),7例患者出现面部肿胀.10例患者均有不同程度嗜酸粒细胞升高.9例患者肝受累.自身抗体异常不常见,部分患者合并病毒感染.10例患者均予糖皮质激素治疗,3例重症患者予静脉输注人免疫球蛋白(IVIg).7例好转出院,2例最终诊为非霍奇金淋巴瘤,1例住院期间死亡.结论 DHS病情复杂,常见致敏药物为抗惊厥药、别嘌呤醇、解热镇痛药及抗生素.部分病例可能存在误诊,需长期随访.
목적 분석약물초민반응종합정(DHS)적림상특점.방법 회고성분석북경협화의원2011년1월지2014년2월주원환자중학진적10례DHS병례자료,귀납기림상특점,총결DHS적발병규률.결과 10례환자중남4례,녀6례.발병년령17 ～66세.가의치민약물분별위항량궐약5례,별표령순2례,항생소1례,대을선안기분1례,불상1례.10례환자균우용약후14 ～60 d출현피진반발열,6례출현림파결종대.피진중이마진양피진최상견(6례),7례환자출현면부종창.10례환자균유불동정도기산립세포승고.9례환자간수루.자신항체이상불상견,부분환자합병병독감염.10례환자균여당피질격소치료,3례중증환자여정맥수주인면역구단백(IVIg).7례호전출원,2례최종진위비곽기금림파류,1례주원기간사망.결론 DHS병정복잡,상견치민약물위항량궐약、별표령순、해열진통약급항생소.부분병례가능존재오진,수장기수방.
Objective To characterize the clinical characteristics of drug hypersensitivity syndrome (DHS).Methods The clinical characteristics of 10 DHS patients admitted into our hospital were analyzed retrospectively.And the occurrence patterns of DHS were summarized.Results There were 4 males and 6 females with an age range of 17 to 66 years.Suspected drugs were anticonvulsants (n =5),allopurinol (n =2),antibiotics (n =1),acetaminophen (n =1) and unknown (n =1).All cases developed skin rashes with fever within 14 to 60 days (n =10).Lymphadenopathy was observed (n =6).Morbilliform eruption was most common skin rash (n =6) ; facial swelling was also appeared (n =7).Eosinophilia was observed in all cases (n =10).Liver involvement was common (n =9).Autoimmune antibodies abnormality was uncommon ; viral infection was complication in several cases.Glucocorticoids were applied in all cases (n =10),3 severe cases were administrated with intravenous immunoglobulin (IVIg).The clinical outcomes included discharging with recovery (n =7),later diagnosed of non-Hodgkin lymphoma (n =2) and inhospital death (n =1).Conclusions The clinical manifestations of DHS are complicated.And the common reactive drugs include anticonvulsants,allopurinol,antiinflammatory drugs and antibiotics.Some cases may be misdiagnosed and long-term follow-ups are required.