196例儿童抗癫痫药物高敏反应综合征临床分析并文献复习

Clinical Analysis of 196 Children with Anti-Epileptic Drug Hypersensitivity Syndrome and Literature Review

目的:探讨抗癫痫药物导致的儿童高敏反应综合征的特征及规律,为抗癫痫药物应用提供参考。方法:筛选和分析国内外公开发表的抗癫痫药物在儿童临床治疗中致高敏反应的文献,对患儿抗癫痫药物高敏反应综合征的临床特点及规律进行分析。结果:共筛选出196例儿童高敏反应综合征病例,临床表现为发热、皮肤损害、淋巴结肿大,重症病例会损伤其他器官和系统。临床治疗以糖皮质激素抗过敏为主,斯-琼综合征及中毒性表皮坏死松解症患儿辅以静脉注射免疫球蛋白。除2例患儿死亡外,其余患儿病情均缓解。结论:抗癫痫药物导致的儿童高敏反应综合征在临床较为常见,不同种类的抗癫痫药物的致敏概率和临床表现存在差异,临床医师、药师应密切关注患儿的体征变化,以确保抗癫痫药物的儿童用药安全。

Objective:To probe into the characteristics and regularities of hypersensitivity syndrome in children induced by antiepileptic drugs,so as to provide reference for the use of anti-epileptic drugs.Methods:Published literature on the clinical treatment of sensitization of anti-epileptic drugs in children at home and abroad were screened and analyzed,the clinical characteristics and regularities of hypersensitivity syndrome of anti-epileptic drugs in children were analyzed.Results:A total of 196 cases of hypersensitivity syndrome in children were screened out.The clinical manifestations were fever,skin damage and lymphadenopathy,severe cases could damage other organs and systems.Clinical treatment was mainly based on glucocorticoid anti-allergy symptomatic treatment.Children with Stevens-Johnson syndrome and toxic epidermal necrolysis were supplemented with intravenous immunoglobulin.Except for two deaths,the rest were relieved.Conclusion:Hypersensitivity syndromein children induced by anti-epileptic drugs is more common in clinical practice,different types of anti-epileptic drugs have different sensitization rates and clinical manifestations.Clinicians and pharmacists should pay close attention to changes of physical signs in children to ensure the medication safety.