醋甲唑胺诱发Stevens-Johnson综合征和中毒性表皮坏死松解症分析

Analysis of Stevens-Johnson syndrome and toxic epidermal necrolysis induced by Methazolamide

目的分析醋甲唑胺诱发的Stevens-Johnson综合征和中毒性表皮坏死松解症。 方法回顾性分析44例由醋甲唑胺诱导的Stevens-Johnson综合征和中毒性表皮坏死松解症的临床资料。对年龄、性别、种族、潜伏时间、临床表现和HLA基因型等进行分析。 结果患者年龄平均（47.63±15.43）岁。醋甲唑胺用量为（90.85±45.51）mg/d。潜伏时间（13.72±8.39）d。初起时皮肤和黏膜皮疹，继而进展至四肢、躯干、面部等，出现皮肤黏膜与其下组织脱离。高峰期结束后，水泡结痂干燥，裂开脱落。26例进行了HLA基因检测，HLA-B59阳性率为88.46%。糖皮质激素的应用是主要治疗手段。 结论醋甲唑胺诱导的Stevens-Johnson综合征和中毒性表皮坏死松解症病情严重，出现可疑症状和体征时应及时停用醋甲唑胺，应用糖皮质激素治疗有望控制病情。

ObjectiveTo analyze Stevens-Johnson syndrome and toxic epidermal necrolysis induced by Methazolamide. MethodsThe clinical data of 44 cases of Stevens-Johnson syndrome and toxic epidermal necrolysis induced by Methazolamide were analyzed retrospectively. The age, gender, race, latent time, main clinical manifestations and HLA genotypes were analyzed. ResultsMean age of all cases was（47.63±15.43） years. The daily dosage of Methazolamide was （90.8±45.51）mg/d. The latent time was （13.72±8.39） days. The early clinical manifestations were skin and mucosa rash, then progressed to the limbs, torso, neck, back and face. Subsequently overspreaded to skin and mucosa blisters, tissue exudation, skin and mucosal detachment, then symptoms decreased. The skin and mucosal blisters became scabby and dry, gradually falling off. HLA gene detection were examined in 26 patients. Twenty-three cases （88.46%） were detected HLA-B59 fragments. The application of glucocorticoid was the main method of treatment. ConclusionStevens-Johnson syndrome and toxic epidermal necrolysis induced by Methazolamide is serious. Once symptoms and signs are suspected, Methazolamide should be stopped immediately, timely using glucocorticoid is expected to control the condition.