中国药物警戒 ›› 2025, Vol. 22 ›› Issue (1): 104-108.
DOI: 10.19803/j.1672-8629.20240320

• 安全与合理用药 • 上一篇    下一篇

763例药疹病例分析

程伟能1, 潘秋娜2, 杨静2, 冯强1, 汤晓萌2, 梁悦2,*   

  1. 1厦门市第五医院药学部,福建 厦门 361000;
    2北京大学深圳医院药学部,广东 深圳 518000
  • 收稿日期:2024-05-16 出版日期:2025-01-15 发布日期:2025-01-22
  • 通讯作者: *梁悦,女,硕士,副主任药师·硕导,微生物与生化药学。E-mail: bmqueen@163.com
  • 作者简介:程伟能,男,硕士,临床药学。

Retrospective Analysis of 763 Cases of Drug Eruptions

CHENG Weineng1, PAN Qiuna2, YANG Jing2, FENG Qiang1, TANG Xiaomeng2, LIANG Yue2,*   

  1. 1Department of Pharmacy, Xiamen Fifth Hospital, Xiamen Fujian 361000, China;
    2Department of Pharmacy, Peking University Shenzhen Hospital, Shenzhen Guangdong 518000, China
  • Received:2024-05-16 Online:2025-01-15 Published:2025-01-22

摘要: 目的 分析药疹的发生特点及临床表现,为临床安全用药提供参考。方法 分别从患者性别、年龄、给药途径、药品种类、严重程度、处理方式等,对医院2019年1月1日至2023年12月31日报告中国医院药物警戒系统的763例药疹患者进行分析。结果 763例药疹患者,其中男性342例(44.82%),女性421例(55.18%)。可疑的致敏药物主要为抗菌药物310例、造影剂160例、抗肿瘤药54例、中成药47例、内分泌系统药47例及消化系统药33例,其中抗菌药物主要为β-内酰胺类及喹诺酮类。药疹发生后,停用可疑致敏药物共729例,未停用34例。268例药疹患者未进行对症治疗,严重及一般药疹发生至好转的时间分别为(1.93±1.22)d及(1.71±1.35)d。495例行药物治疗,主要选用抗组胺药、激素类药品、葡萄糖酸钙及炉甘石洗剂,其中抗组胺药主要选用氯雷他定,激素类药物主要选用地塞米松,严重及一般药疹发生至好转的时间分别为(2.40±2.36)d及(1.80±1.41)d。对症治疗的患者中,301例单药治疗,194例联合治疗。结论 不同类型药物,其药疹的发生率及严重程度存在差异,可根据药疹的严重程度决定是否停药及对症处理,单药治疗是治疗轻度药疹的主要选择,可根据患者病情变化决定是否联合用药。

关键词: 药疹, 药品不良反应, 抗菌药物, β-内酰胺类, 对症治疗, 严重程度, 抗组胺药, 激素

Abstract: Objective To analyze the incidence and clinical manifestations of drug eruptions and to provide a reference for safe clinical use of drugs. Methods The 763 cases of drug eruptions reported to the Adverse Drug Reaction Monitoring System by the hospital between 2019 and 2023 were analyzed in terms of the patients' gender, age, routes of administration, types of drugs, severity and treatments, respectively. Results There were 763 cases of drug eruptions, including 342 males (44.82%) and 421 females (55.18%). Suspected sensitizing medications involved antimicrobial agents in 310 cases, contrast agents in 160 cases, antitumor medications in 54 cases, Chinese patent medications in 47 cases, endocrine medications in 47 cases, and digestive system medications in 33 cases. The chief culprits among antibiotics were β-lactam antibiotics and quinolones. After the onset of drug eruptions, the suspected sensitizing medications were discontinued in 729 cases but continued in 34 cases. Among the 268 patients with drug eruptions who did not receive symptomatic treatment, the interval from occurrence to improvement for severe and mild drug eruptions was (1.93±1.22) days and (1.71±1.35) days, respectively. Four hundred and ninety-five cases received medications, involving antihistamines, glucocorticoids, calcium gluconate and glycerite lotion. Among them, loratadine was primarily used as the antihistamine, and dexamethasone was as the hormone drug. The time from occurrence to improvement of severe and mild drug eruptions was (2.40 ± 2.36) days and (1.80 ± 1.41) days, respectively. Among the symptomatically treated patients, 301 were treated with monotherapy alone, while 194 were treated with combination therapy. Conclusion There are differences in the incidence and severity of drug eruptions between different types of drugs. The decision to discontinue the drug and symptomatic management can be made according to the severity of drug eruptions. Monotherapy is the first option for the treatment of mild drug eruptions, and combination therapy can be determined based on changes in the patient's conditions.

Key words: Drug Eruptions, Adverse Drug Reaction, Antimicrobial, Beta-Lactams, Symptomatic Treatment, Severity, Antihistamines, Glucocorticoids

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