药物超敏反应综合征研究进展

Research Progress of Drug-induced Hypersensitivity Syndrome

药物超敏反应综合征(DIHS)是一种威胁到生命的全身反应,以皮疹、发热、肝炎、淋巴结病和伴嗜酸性粒细胞增多性白细胞增多症为特征的综合症候群。原因药物多为芳香族抗惊厥剂,也可由其他药物如磺胺类、非甾体抗炎药等引起。其发病机制尚不明确,但病毒再活化、药物解毒功能缺陷及超敏反应机制是研究热点。治疗主要包括立即停用致敏药物、对症治疗、系统性应用激素或者免疫球蛋白。一经诊断,治疗通常是有效的,但仍有20%的DIHS患者死亡。

Drug-induced hypersensitivity syndrome（DIHS） is a life-threatening systemic reaction characterized by rash,fever,hepatitis,lymphadenopathy and leukocytosis with eosinophilia.Causative drugs mianly are aromatic antiepileptic drugs.It can also be caused by other drugs,such as sulfonamides,nonsteroidal anti-inflammatory drugs and so on.The pathogenesis of DIHS is still not clear,but herpesvirus reactivation,the defect of detoxification system and allergic reaction pathogenesis are hot topics.Management mainly includes immediate withdrawal of the culprit drug,symptomatic treatment and systemic steroids or immunoglobulins.Once diagnosed,the therapy is often successful.However DIHS leads to death in about 20% of cases.