大疱性表皮坏死松解型药疹64例回顾性分析

A Retrospective Study of 64 Patients with Bullous Epidermo-necrolysis Type of Drug Eruption

目的 探讨大疱性表皮坏死松解型药疹的发病规律及诊治经验。方法 回顾研究了 64例住院治疗的该型药疹患者。结果 致病药物包括抗生素 (头孢类抗生素、青霉素为主 ) ,解热镇痛药 (安乃近为主 ) ,磺胺药 ( SMZco)以及抗痛风药 (别嘌呤醇 )等。 5 7例 ( 89.1% )皮损累及全身 ,5 6例 ( 87.5 % )伴有不同程度的粘膜损害。死亡 14例( 2 1.9% ) ,继发感染是主要死因 (占死因的 64 .3 % )。结论 大疱性表皮坏死松解型药疹的预后与及时停用过敏药物、年龄、皮损范围、皮质类固醇激素起用时间、血尿素氮水平。

Objective To investigate the law of episode and experience of diagnosis and treatment of bullous epidermo-necrolysis type of drug eruption. Methods A retrospective study was performed on 64 patients with bullous epidermo-necrolysis type of drug eruption. Results The main causative drugs included antibiotics(cephalosporins, penicillin etc.), antipyretics(analgin, compound amidopyrine, etc.), sulfonamide (SMZco) and anti-gout drug(allopurinol), etc. Almost all of the body surface was involved in 57 cases(89.1 %). Erosive mucous membrane lesions were presented in 56 cases (87.5 %). The mortality rate was 21.9 %. Secondary infection was the main cause of death. Conclusion Some factors including stop using allergic drug in time, age, extent of necrolysis, administration of corticosteroid, serum urea nitrogen level, secondary infection and body status of patients were correlated with the prognosis.