系统性红斑狼疮与药物变态反应的临床研究

Drug allergies in systemic lupus erythematosus

目的分析系统性红斑狼疮(Systemic lupus erythematosus,SLE)患者药物变态反应的发生率、发生变态反应的药物种类及变态反应的严重程度。方法对426例在本院风湿科住院的SLE患者及204例在本院内科住院的慢性病患者(包括高血压、糖尿病、慢性支气管炎、慢性肾脏疾病、冠心病和其他慢病患者62例)进行回顾性分析,记录患者的人口统计学资料、用药史、药物变态反应种类、临床表现和严重程度。结果 426例SLE患者中有121例患者(28.40%)发生了药物变态反应,204例普通内科慢性病患者组中有26例患者(12.75%)发生了药物变态反应(P<0.05)。在SLE组,最常见的易发生变态反应的抗生素是青霉素类56例(13.15%),其次是头孢类抗生素54例(12.68%),中药注射剂25例(5.87%),大环内酯类16例(3.76%)和喹诺酮类16例(3.76%)。皮疹是药物变态反应最常见的临床表现。SLE组中对6种药物均发生变态反应的有2例患者,对5种药物发生变态反应者3例,4种药物者5例。结论药物变态反应在SLE患者中较常见,SLE患者可以同时对多种药物发生变态反应,青霉素是最常见的变态反应药物,中药注射剂也易发生变态反应,需引起重视。

Objective To analyze the frequency of drug allergies in patients with systemic lupus erythematosus （SLE）,and register the causal drug,the type,and the severity of drug reaction.Methods Retrospective investigation and analysis were carried out in 426 patients with SLE and 204 patients with other chronic diseases （including of hypertension,diabetes mellitus,chronic bronchitis,chronic kidney disease,coronary heart disease,and other chronic disease）.Demographic data,drug allergies （including the causal drug,the type and the severity of allergic reaction）were registered.Results Drug allergies were reported in 28.40％ （121/426） patients with SLE and 12.6％ （26/204）patients with other chronic diseases （P＜0.05）.The allergy rates of penicillin was 13.15％,cephalosporin antibiotics of 12.69％,Traditional Chinese Medicine injection of 5.87％,macrolides of 3.76％ and quinolones of 3.76％.Most of them presented skin rash as their clinical expression of allergy.Two patients with SLE were allergic to six drugs,and three patients were allergic to five drugs and five patients were allergic to four drugs.Conclusion Drug allergies are more frequent in SLE than that in other chronic diseases.Patients can be allergic to many drugs.Penicillin drugs are still the most frequent cause of drug allergies in SLE.Traditional Chinese medicine injection is also prone to allergy in patients with SLE.