289例药疹临床分析

Clinical analysis of 289 cases with drug eruption

目的:探讨临床应用药物与药疹发生的关系以及药疹的防治。方法:对我院皮肤科自2000年1月～2006年12月间因药疹到门诊就诊或住院的患者的临床资料进行分析。结果:289例患者中有196例可明确为1种致敏药物,占67.8%(196/289)。由青霉素类引起的药疹共有71例,占36.2%(71/196),其中阿莫西林45例,安西林21例,苄星青霉素G5例。磺胺类引起的药疹共有36例,占18.4%(36/196)。解热镇痛药引起的药疹共有56例,占28.6%(56/196),其中扑热息痛24例,吲哚美辛26例。青霉素类及解热镇痛药引起的药疹中重症药疹分别占8.5%(6/71)及8.9%(5/56)。巴比妥类引起的药疹共13例,占6.6%(13/196),其中重症药疹占38.5%(5/13)。治疗所需的糖皮质激素控制剂量多为80～120mg/d,病程较长。结论:青霉素类、解热镇痛类及磺胺类药物是引起药疹最常见的药物。引起重症药疹的药物主要为青霉素类、解热镇痛药以及巴比妥类。

Objective To discuss the connection between clinical drugs and drug eruption as well as the prevention of drug eruption. Method The clinical data were analyzed for drug eruption of out - patients or in - patients in the department of dermatology in our hospital from January 2000 to December 2006. Results For 196 out of 289 patients were confirmed to be caused by a sensitizing drug （67.8% in ratio）. Seventy -one cases were caused by BenzylpeniciUin （36.2%）, including 43 by Amoxicillin, 21 by Ancillin and 5 by Benzathine Benzylpenieillin. Thirty - six eases were caused by Sulfanilamide （ 18.4% ）. Fifty - six cases were caused by non - steroidal antiinflammatory drugs （28.6%）, including 24 by Paracetamol Granules and 26 by indometacin. Among those caused by Benzylpenicillin and non - steroidal antiinflammatory, 8.5% （6/71） and 8.9% （5/56） were severe. In addition, 13 cases were caused by Barbital （6.6%） , including 38.5% （5/13） severe cases. Dosage control of Glucocorticoids for treatment was 80 -120 mg/d and the duration of treatment was a bit longer than normal. Conclusion Benzylpenicillin, non - steroidal antiinflammatory and Sulfonamides are the most common drugs that might cause drug eruption. Drugs that might cause severe drug eruption include enzylpenicillin, non - steroidal antiinflammatory and Barbital.