186例药疹患者的致敏药物及临床分型

Clinical Analysis of 186 Outpatients with Drug Eruption

目的分析北京同仁医院皮肤科2004年1月2006年6月,门诊药疹患者的致敏药物及临床分型。方法收集2004年1月2006年6月间的药疹门诊患者临床资料,对其致病药物及药疹类型进行分析。结果共收集药疹病例186例,常见致敏药物中抗生素类占38.7%,中成药类占26.9%,多种药物合用致敏占19.9%,解热镇痛类占3.8%,生物制品和精神神经类各占2.1%,原因不明占6.5%。主要的药疹类型为麻疹及猩红热样发疹型占69.4%、荨麻疹型占18.8%、固定型占7.0%。引起麻疹及猩红热样发疹型、荨麻疹型药疹的主要致敏药物均为抗生素类,分别占34.9%和45.7%,其次是中成药,分别占27.9%和34.3%。重症药疹如重症多形性红斑、剥脱性皮炎主要由抗生素引起,也可以由中药引起。结论本组病例中引起药疹的主要致敏药物为抗生素和中成药。由中药引起的药疹比例大幅度增加,应引起足够重视。

Objective To study the causative agents and the clinical features of drug eruption of outpatients in our hospital from 2004 to 2005. Methods The clinical data of drug eruption in 186 outpatients were collected from 2004 to 2005 and the causative agents and clinical patterns were analyzed. Results 186 patients were enrolled in this study. The drugs most often responsible for the drug eruption were antimicrobials （ 38.7% ） and Chinese patent medicine （ 26. 9% ）. The most common clinical types were morbiliformscarlatiniform exanthesis （69.4%） , urticaria （ 18.8% ） and fixed drug eruption （7.0%） . The main causative agents of morbiliformsarlatiniform exanthesis type and urticaria were antimicrobials（34.9% , 45.7% ） and Chinese patent medicine（27.9% , 34.3% ）. The main causative drugs of life-threatening Steven-Johnson syndrome and dermatitis exfoliativa were antimicrobials and traditional Chinese medicine. Conclusion The most common causative agents in this study were antimicrobials and traditional Chinese medicine. More attention should be paid to increasing of drug eruption caused by traditional Chinese medicine, although most of them were gentle or midrange.