破伤风抗毒素致不良反应158例文献分析

Literature analysis of 158 cases of adverse drug reactions caused by tetanus antitoxin

目的探讨破伤风抗毒素致不良反应的一般规律,为临床安全用药提供参考。方法以"破伤风抗毒素""TAT"为检索词,检索中国知网(CNKI)、万方数据库、维普期刊全文数据库1996-01至2016-10收录的有关破伤风抗毒素引起不良反应的文献资料,筛选并收集相关报告,按年龄、性别、给药途径、原患疾病、不良反应发生时间、累及器官/系统及临床表现、过敏史、转归等进行统计、分析。结果经检索,破伤风抗毒素致不良反应文献145篇,共158例。不良反应在20~39岁的人群发生最多(58.23%);用药20 min内不良反应发生率高达43.04%,主要累及全身性损害(89.24%),临床主要表现为过敏性休克(46.84%)、过敏反应(39.87%)、血清病(2.53%)。156例好转或痊愈(98.73%),2例死于过敏性休克(1.27%)。结论临床应警惕破伤风抗毒素引起的过敏性休克等严重不良反应,确保用药安全。

Objective To study adverse drug reactions（ ADRs） caused by tetanus antitoxin and provide reference for safe use of drugs in clinic. Methods Literature on ADRs caused by tetanus antitoxin,which was published between January 1996 and October2016,was retrieved from Wanfang database,CNKI and VIP database with ＂tetanus antitoxin＂and＂TAT＂as the key words. Related reports were collected and analyzed in terms of age,gender,routes of administration,primary diseases,the time of occurrence of ADRs,human organs or systems involved,allergy history,clinical manifestations and the results. Results A total of 145 pieces of literature,including 158 cases of ADRs caused by tetanus antitoxin,were retrieved. ADRs caused by tetanus antitoxin often occurred among people aged 20 to 39（ 58. 23%）. ADRs occurred within 20 min after medication（ 43. 04%）,and were mainly manifested as systemic damage（ 89. 24%）. Clinical manifestations were mainly allergic shock（ 46. 84%）,allergic reaction（ 39. 87%） and serum sickness（ 2. 53%）. 98. 73% of the cases were improved or cured after symptomatic treatment,but there were two cases（ 1. 27%） of death.Conclusions Doctors should be alert to severe ADRs caused by tetanus antitoxin,such as allergic shock,to ensure drug safety.