二巯丙磺钠注射液驱铜治疗致过敏反应回顾性分析

Retrospective Analysis of Allergic Reaction Induced by Anti-copper Treatment with Sodium Dimercaptopropane Sulfonate Injection

目的：探讨二巯丙磺钠注射液在肝豆状核变性驱铜治疗中致过敏反应的临床特点和规律,为该药致过敏反应诊断、治疗和监测提供参考。方法：采用回顾性分析的方法,对我院2013年1月-2015年12月收集的二巯丙磺钠注射液致过敏反应报告进行统计和分析。结果：共获得过敏反应报告131例;患者平均年龄（23.26±9.63）岁,多集中在10~39岁（87.79%）;过敏反应出现在第1、2疗程最多（71.76%）。累及器官/系统以皮肤及附件损害最多（85.90%）,其中以四肢（27.45%）和躯干（22.22%）最多;其次为全身系统损害（12.33%）,临床表现主要为发热,发热多与皮疹或瘙痒同时出现。过敏反应经治疗后均转归良好,115例（87.79%）患者在7 d内症状消失。严重的ADR占25.19%,严重的ADR患者药物过敏史比例、采用预防过敏或脱敏治疗继续驱铜失败率和症状持续时间均高于或长于一般的ADR患者,差异均有统计学意义（P〈0.05）。结论：二巯丙磺钠注射液所致过敏反应增加了驱铜治疗的困难,故应加强不良反应监测,尤其应关注有过敏史和第1、2疗程的患者。

OBJECTIVE：To investigate the clinical characteristics and rules of allergic reaction caused by anti-copper treatment with Sodium dimercaptoproane sulfonate（DMPS）injection,and to provide reference for diagnosis,treatment and monitoring of drug-induced allergic reaction. METHODS：By using retrospective analysis,allergic reaction reports of DMPS injection were selected from our hospital during Jan. 2013-Dec. 2015 were analyzed statistically. RESULTS：A total of 131 cases of allergic reaction were reported. The average age of the patients was（23.26±9.63）years old,mainly concentrated on 10-39 years old（87.79%）. Allergic reaction mainly occurred in the first and second courses of treatment,accounting for 71.76%. For systems-organs involved,skin and its appendages disorders had the highest proportion（85.90%）,being mainly the lesion of limbs（27.45%） and body（22.22%）involved;followed by systemic damage（12.33%）. Clinical manifestations of systemic impairment were mainly fever,with rash or itching at the same time frequently. 131 patients had good outcome after treatment. The symptoms of 115 patients（87.79%）disappeared in 7 d. Serious cases accounted for 25.19%. The proportion of drug allergy history,the rate of anti-copper treatment failure with allergy prevention or desensitization therapy,and symptom duration in patients with severe ADR were higher or longer than that in general ADR cases,the difference was statistically significant（P〈0.05）. CONCLUSIONS：The allergic reaction of DMPS injection increased the difficulty of anti-copper treatment. ADR monitoring should be strengthened in the process of using DMPS,specially for the history of allergies and the first,second treatment courses of patients.