药物超敏综合征35例临床分析

Clinical analysis of 35 patients with drug-induced hypersensitivity syndrome

对我院皮肤科35例药物超敏综合征患者资料进行回顾性分析,潜伏期20~50天,均有明确用药史,其中别嘌醇16例、卡马西平9例,磺胺类药7例,苯妥英钠2例,抗结核药1例。皮疹表现为麻疹样或猩红热样型24例,多形红斑型6例,剥脱性皮炎型5例。35例患者均有发热、白细胞升高和肝功异常。此外,淋巴结肿大27例,肝脏肿大20例,黄疸6例,血嗜酸粒细胞增高30例,周围血中发现异型淋巴细胞18例,血小板降低4例。35例患者均给予糖皮质激素治疗,病情严重者加用免疫球蛋白等联合治疗。34例患者痊愈出院,1例死亡。

The clinical data of 35 patients with drug-induced hypersensitivity syndrome （ DIHS） were analyzed retrospectively. Incubation of DIHS in the 35 patients was 20 to 50 days. All patients were confirmed to be caused by one drug. Sixteen patients were caused by allopurinol, 9 by carbamazepine, 7 by sulfonamides, 2 patients by phenytoin sodium and one by antituberculosis drug. The eruption was measles-like or scarlet fever-like types （ 24 patients） , erythema multiforme type （ 6 patients） and exfoliative dermatitis type （ 5 patients） . All patients were accompanied by fever, leukocytosis and abnormal liver function. In addition, there were lymphadenectasis in 27 patients, hepatomegaly in 20, jaundice in 6, eosinophilia in 30 atypical lympho-cytes in peripheral blood in 18 and reduction of platelet in 4. These patients were treated with glucocorticoids and immunoglobulins. Thirty-four patients recovered and one died.