239例卡马西平药疹的临床荟萃分析

Literature Analysis of 239 Patients with Drug Eruption Induced by Carbamazepine

目的探讨国人因卡马西平所致药疹的临床特点及预后转归。方法通过中国医院知识数据库(CHKD),以"卡马西平and药疹and临床分析"为关键词,对1996年1月至2011年12月发表的中文文章进行检索,提取其中有关卡马西平药疹患者的临床资料并进行汇总分析。结果共11项临床分析中的239例患者进入本研究,其中男130例,女109例。平均发病年龄为39.13岁。男女比例接近。卡马西平药疹重症型的发生率达59.18%,皮损类型由高到低依次为:SJS、ED、TEN。潜伏期平均为11.91d,平均住院时间为28.70d。卡马西平重症药疹患者出现发热的比例为100%,血白细胞数目异常者占51.46%,有肝功能损害的占66.02%,肾功能损害的占31.07%。其他常见的还有高血糖、尿血及尿蛋白等异常。卡马西平药疹的治愈率为94.57%,无明确死亡病例报道。结论我国卡马西平药疹的发病以青壮年为主,临床表现可以多种多样,潜伏期长,发生重症的比例比普通药疹高,常伴多系统损害,在临床工作中应高度重视。

Objeetive To analyze the clinical features and prognosis of the carbamazepine-induced drug eruption. Methods The literatures published from 1996.1 to 2011.12 in CHKD with the keyword ＇carbamazepine and drug eruption and clinical analysis＇ were reviewed and the clinical data of carbamazepine- induced drug eruption patients were analyzed. Results In 239 patients of 11 clinical studies, there were 130 males and 109 females. The mean onset age was 39.13 years old. Among them 59.18% were severe subtypes, in which the percentage of febricity, WBC anomaly, hepatic and renal dysfunction was 100%,51.46%, 66.02% and 31.07% respectively. The total cure rate was 94.57% and no case died. The latent period was 11.91 days and the average length of stay was 28.70days. Conclusion Carbamazepine-induced drug eruption has a higher incidence in the middle-age. Its clinical manifestations can be various and more likely to become severe subtypes that combined with systemic damages. It is necessary for clinicians to pay attention to this kind of drug eruption.