别嘌醇所致药疹的临床特征及其肾功能与预后的关系

Clinical features of allopurinol-induced drug eruption and the relationship between renal function and prognosis

目的:探讨别嘌醇引起药疹的临床特征以及病情轻重、预后与肾功能的关系。方法:对1995-2010年复旦大学附属华山医院病房收治的156例别嘌醇药疹进行回顾性分析。结果:别嘌醇引起药疹的潜伏期为(41.8±14.3)d,病人住院时间为(36.8±11.2)d,重症多形红斑型、剥脱性皮炎型及大疱性表皮坏死松解型药疹占42.3%,全身症状重,死亡12例。病情轻重与肾功能损害的程度密切相关(P<0.05),疾病的预后也与肾功能损害的程度密切相关(P<0.01)。结论:别嘌醇所致的药疹具有潜伏期长、病程长、皮疹重、全身症状重等特点,其肾功能损害的程度可影响病情的轻重和疾病的预后。

Objective： To investigate the clinical features of allopurinol-induced drug eruption and the relationship between severity of illness and prognosis of the disease and renal function. Methods： One hundred and fifty six hospitalized patients with allopurinol-induced drug eruption admitted to Huashan Hospital from 1995 to 2010 were retrospectively analyzed. Results： The incubation period of allopurinol-induced drug eruption was （41.8±14.3） d, and the duration of hospitalization was （36.8±11.2） d. Severe erythema muhiforme, exfoliative dermatitis and bullous epidermal necrolysis accounted for 42.3 % of the drug eruption. Severe systemic symptoms were noted in the severe patients, and 12 cases died. The severity of the disease was closely related to the extent of renal dysfunction （P〈0.05）. The prognosis of the disease was also significantly related to the extent of renal dysfunction （P〈0.01）. Conclusion： The eruption caused by allopurinol was characterized by longer incubation period and longer course of illness, severe skin eruption and constitutional symptoms, and the extent of renal dysfunction were closely related to the severity and prognosis of the disease.