抗结核药物所致皮疹临床特点及停药指征的探讨

Discussion on the clinical characteristics of skin rash caused by the anti-tuberculosis drugs and its indicators to stop using the drugs

目的探讨抗结核药物所致皮疹的临床特点及停药指征。方法对1998—2005年收治的3 082例住院结核病人中,因抗结核药物所致皮疹296例病人进行分析。结果变态反应总发生率为10.3%,皮疹发生率为9.6%(296例),其中单纯皮疹88例,占2.9%,皮疹伴其他系统表现一种或一种以上者208例,占6.7%;无皮疹者22例,占0.7%。皮疹病例总停药率为61.5%。结论抗结核药物所致过敏反应多为全身性,发生过敏反应后,绝大多数单纯皮疹病人经过抗过敏处理后仍可维持原方案继续治疗,而皮疹伴有明显肝功能异常、心律失常、关节痛和过敏性休克者均需立即停用抗结核药物,并且避免再次使用。

Objective To study the clinical characteristics of skin rash caused by the anti-tuberculosis（TB） drugs and its indicators to stop using the drugs. Methods 296 TB patients with skin rash caused by anti-TB drugs out of the 3082 hospitalized TB patients admitted during 1998 and 2005 were analyzed. Results The total rate of metamorphic reaction was 10.3%. The rate of skin rash was 9.6% （296 cases）, among whom 88 were pure skin rash accounting for 2.9 %, 208 were the skin rash with one or more other systemetical symptomes, accounting for 6.7 % ; 22 were without skin rash, accounting for 0.7 %. The total rate of stopping the use of the drug was 61.5%. Conclusion Most of the allergic reactions caused by anti-TB drugs were systematic. With anti-allergy treatment, most patients with pure skin rash can continue the previous treatment, while the patients with other symptoms such as obvious abnormal liver function, arrhythmia, joint pain and allergic shock must stop using the anti-TB drugs immediately, and avoid using the drugs any more.