多粘菌素B导致成人皮肤色素沉着的文献分析

Literature analysis of skin pigmentation in adult patients induced by polymyxin B

目的:调查多粘菌素B引起成人皮肤色素沉着的临床特征、发生原因及预防治疗措施。方法:以“多粘菌素”或“粘菌素”、“皮肤色素沉着”为中文主题词检索CNKI和万方数据库,以“polymyxin”,“colistin”,“CMS”以及“skinpigmentation”为英文主题词检索PubMed、ScienceDirect、Embase、WileyOnlineLibrary数据库,选择使用多粘菌素B后出现皮肤色素沉着的成人病例,对患者的种族、性别、年龄、用药剂量和时间情况、合并用药及不良反应特点等进行分析。结果:共检出有效文献6篇,纳入病例36例(含2例未发表数据)。皮肤色素沉着通常在多粘菌素B治疗前期出现,起始好发于头面部、颈部、胸部等部位,随治疗过程逐渐加重并蔓延至全身,停药后缓解较慢,至少需要数月时间。该类不良反应的具体机理尚不明确,可能与疗程长短、累积剂量等相关。结论:皮肤色素沉着为多粘菌素B独特的不良反应,可能会影响患者的生活质量,需要进一步关注和研究。

Objective: To investigate the clinical features, causes and preventive measures of polymyxin B-induced skin pigmentation in adult patients. Methods: Databases of CNKI, WanFang, PubMed, ScienceDirect, Embase, Wiley Online Library were retrieved by using the key words including polymyxin, colistin, CMS and skin pigmentation. Adult cases of skin pigmentation induced by polymyxin B were collected. The race, gender, age of patients, dose and duration of polymyxin B, drug combination and the clinical manifestations were analyzed. Results: A total of 6 valid articles were detected and 36 cases were included (including 2 unpublished cases). Skin pigmentation usually occurred in the early stage of polymyxin B treatment. It started from the head, face, neck, chest and gradually spreaded to the whole body. It might take several months to relieve. The mechanism of this adverse drug reaction was unclear, which might be related to course of polymyxin B therapy, accumulated dose and so on. Conclusion: Skin pigmentation might be a unique adverse reaction of polymyxin B, which might affect the quality of the life and needed further attention and research.