头孢菌素类抗生素致过敏性休克文献调查

Literature review of the allergic shock induced by cephalosporins

目的:了解头孢菌素类抗生素致过敏性休克的发生规律、相关因素和预后情况,为临床合理用药提供依据。方法:对国内1990年以来有关头孢菌素类致过敏性休克的病例报道210篇244例进行分析整理。结果:244例过敏性休克涉及12种药物,居前6位的是头孢唑林、头孢噻肟、头孢氨苄、头孢哌酮、头孢曲松、头孢拉定,占93.8%。有过敏史者24.6%,无过敏史者30.3%,过敏史不清者45.1%。86.1%的过敏性休克发生于用药的20min内,首次用药占78.7%,死亡占8.2%。结论:头孢菌素类致过敏性休克应引起医药人员高度重视,用药前仔细询问过敏史,有过敏史者做皮肤过敏试验及用药后密切观察是防治严重过敏事件的重要措施。

Objective: To investigate the the allergic shock induced by cephalosporins. Methods: Literature was retrieved from domestic medical journals 1990-2003,and 244 cases with allergic shock in 210 papers were collected and analysed. Results: Twelve cephalosporins were involved in 244 cases and 93.8% of them were caused by six cephalosporins, namely, cefazolin, cefotaxime, cephalexin, cefoperazone, ceftriaxone and cefradine. The patients with and without allergic history accounted for 24.6% and 30.3% respectively and the others were unknown in this respect. 78.7% of the cases occurred during first administration and 86.1% did within 20 minutes of drug start. The mortality rate was about 8.2%. Conclusion: Cephalosporins could result in allergic shock and much attention should be especially paid to the patients with allergic history.