非动物源性胰岛素所致过敏反应的文献汇总与分析

Literature analysis on allergic reaction caused by non-animal derived insulin

目的通过对国内外非动物源性胰岛素过敏现状及相关因素汇总分析,旨在为临床医护人员合理安全使用胰岛素制剂提供参考。方法以"胰岛素""过敏""超敏"为检索词,检索中国知网、万方、维普、PubMed等数据库自2010年1月至2021年1月有关非动物源性胰岛素过敏的中英文文献,对非动物源性胰岛素引起的过敏反应病例进行统计分析。结果共检索到符合要求的文献100篇,纳入133例病例。其中50~60岁患者居多(33.08%);使用胰岛素的原因以2型糖尿病居多,占比68.42%;胰岛素类似物引起的过敏反应最多,以门冬胰岛素30(20.22%)和甘精胰岛素(13.72%)为主;过敏反应类型大多是局部过敏反应(81.95%),过敏反应大多发生在半个月之内(54.87%)。结论非动物源性胰岛素引起的过敏反应仍然存在,严重者可导致过敏性休克。使用时应考虑患者年龄、胰岛素类型及过敏史等各种因素,确保用药的安全性,减少过敏反应的发生,提高患者使用胰岛素的安全性和舒适性。

Objective This study was designed to analyze the current situation and related factors of non-animal derived insulin allergy at home and abroad,and provide reference for clinical use of insulin preparations reasonably and safely. Methods Based on the key words of "insulin", "allergic" and"insulin",this paper searched the literatures on non-animal derived insulin allergy through the databases of CNKI,Wanfang,VIP and PubMed from January 2010 to January 2021. Allergic reactions caused by non-animal derived insulin were statistically analyzed. Results A total of 100 literatures were retrieved and 133 cases were included. The majority of patients aged 50-60 years(33. 08%);the most common reason for using insulin is type 2 diabetes,accounting for 68. 42%;the most allergic reactions caused by insulin analogues,mainly insulin aspart 30(20. 22%)and insulin glargine(13. 72%). Mainly allergic reactions are mostly local allergic reactions(81. 95%),and most allergic reactions occur within half a month(54. 87%). Conclusion Allergic reactions caused by non-animal derived insulin still exist,and severe cases can lead to anaphylactic shock. Various factors including age,insulin type,allergy history should be considered to ensure medication safety,reduce the occurrence of allergic reactions and improve the safety and comfort of patients using insulin.