重型药疹的静脉注射用丙种球蛋白治疗

IVIG Treatment of Severe Drug Eruptions

重型药疹是一种病情危重、死亡率较高的疾病。临床上以大面积皮肤和黏膜红斑、水疱,甚至糜烂、渗出为主要表现,常伴发各种感染、水/电解质代谢紊乱以及重要器官功能障碍等。抗生素、抗癫痫药、非甾体抗炎药为诱发重型药疹的常见药物。重型药疹的治疗包括大剂量糖皮质激素、静脉注射用丙种球蛋白(IVIG)以及环磷酰胺、环孢素、肿瘤坏死因子α拮抗剂、血液透析、血浆置换等。其中IVIG因其有效性和安全性而被广泛应用,但其疗效又缺乏完整的循证学证据支持。文中就IVIG治疗重型药疹的现况进行了概述,为更有效应用IVIG抢救重型药疹提供一定的参考。

Severe drug eruptions are serious and life-threatening diseases. Wide spread rash,bullae,erosion and exudation of skin and mucosa accompanied with infections,metabolic abnormalities,multiorgan dysfunction are their clinical manifestations. Antibiotics,anticonvulsants,and nonsteroidal anti-inflammatory drugs are the common causes of these diseases. systemic corticosteroids,immunoglobulins（ IVIG）,cyclosporine, cyclophosphamide, plasmapheresis,and tumor necrosis factor-alpha inhibitors could be employed as treatments. IVIG is widely used these days,but without complete randomized controlled trials supported. This review collected and analysised the literaturesof IVIG in the treatment of severe drug eruptions,aid to improve the treatmentof thesesevere diseases.