别嘌呤醇致重症药疹9例临床分析

Clinical Analysis of 9 Cases with Severe Drug Eruption by Allopurinol

目的探讨别嘌呤醇致重症药疹的临床特点。方法对9例别嘌呤醇致重症药疹患者的临床表现、实验室检查、治疗、预后进行回顾性分析。结果别嘌呤醇所致重症药疹包括重症多形红斑型、表皮坏死松解型、剥脱性皮炎型。潜伏期长、病情急重、肝肾受累常见、糖皮质激素治疗有效,但病程长、死亡率高。结论别嘌呤醇致重症药疹应用皮质类固醇激素治疗时宜早期、足量、足疗程、缓慢减量。

Objective To study of the clinical feature of severe drug eruption by allopurinol. Methods retrospective analysis of 9 cases of severe drug eruption by allopurinol was made in detail ; including clinical situation, laboratory examination, treatment and prognosis. Results Severe drug eruption by allopurinol had four types：erythema multiforme gravis or Steven-Johnson syndrome,epidermal necrolysis and exfoliative dermatitis. It was characterized by long-incubation period, critical situation, hepatic and renal dysfunction, effective response to corticosteroid therapy, long duration and high mortality. Conclusion The principals of corticosteroid therapy in severe drug eruption by allopurinol are early using, sufficient dose, enough duration and gradually reduction.