341例药疹临床回顾性分析

目的：了解药疹的类型及其相关致病药物,以有助于临床对药疹的诊治。方法：收集2002年1月至2007年12月门诊药疹患者的临床资料,对药疹的潜伏期、致病药物、类型、治疗及转归进行回顾性分析。结果：共341例患者纳入研究,其中男165例,女176例,年龄3～90岁,平均年龄（45.67±19.98）岁。298例患者有明确的潜伏期,其中247例（82.89%）≤1周,28例（9.40%）为～2周,23例（7.71%）〉2周。293例（85.92%）为单一用药,引起药疹的常见药物有β-内酰胺类（68例,32.2%）,解热镇痛药（49例,16.72%）,喹诺酮类（32例,10.92%）,中成药（30例,10.24%）,磺胺类（29例,9.90%）;其他致病药物有心血管药物、抗癫痫药、生物制品以及镇静催眠药等。药疹的类型有：麻疹样或猩红热样疹（发疹样疹）（147例）、荨麻疹（71例）,固定性药疹（60例）、多形红斑（7例）、紫癜性疹（4例）、湿疹样疹（2例）、重症多形红斑（1例）及痤疮样疹（1例）。发疹样疹主要由β-内酰胺类（49例）、喹诺酮类（18例）、解热镇痛药（18例）及中成药（16例）所致。荨麻疹主要由喹诺酮类（10例）所致。固定性药疹主要由磺胺类（28例）及解热镇痛药（22例）所致,所有患者经用抗组胺药物、皮质激素以及对症支持治疗后全部痊愈。结论：发疹样疹为常见药疹,其次为荨麻疹和固定性药疹。引起药疹的主要药物为β-内酰胺类抗生素、解热镇痛药、喹诺酮类、中成药,以及磺胺类药物。

Drug eruptions: clinical retrospective analysis of 341 cases

Objective： To understand the types of drug eruptions and their causative agents in order to help clinicians to diagnose and treat drug eruptions. Methods： The clinical data from outpatients between January 2002 and December 2007 were collected. The latent period, causative agents, type, treatment, and outcome of drug eruptions were analyzed retrospectively. Results： A total of 341 patients[ 165 men and 176 women aged 3 -90 years, average age （45.67 ± 19.98） years ] were enrolled in a study. Two hundred and ninety-eight patients of them had a certain latent period. The latent period from exposure to onset of symptoms was ≤ 1 week in 247 cases （82.89%）, -2 weeks in 28 cases （9.40%） and 〉 2 weeks in 23 cases （7.71%）. Two hundred and ninety-three patients （85.92%） received monotherapy. The common agents causing drug eruptions were β-1actam antibiotics （68 cases, 32. 2% ）, analgesic-antipyretic agents （49 case, 16. 72% ）, quinolones （32 cases, 10. 92% ）, Chinese patent medicines （30 cases, 10. 24% ）, and stdfonamides （29 cases, 9.90% ）. Other causative agents included cardiovascular agents, antiepileptics, biological products, sedatives and hypnotics. The types of drug eruptions were morbilliform or scarlatiniform exanthema （exanthematous eruption） （147 cases）, urticaria （71 cases）, fixed drug eruption （60 cases）, erythema multiform （7 cases）, purpuric eruption （4 cases）, eczematid （2 cases）, severe erythema multiform （1 case）, and acneiform eruption （1 case）. Exanthematous eruption is mainly caused by β-1actam antibiotics （49 cases）, quinolones （18 cases）, analgesic-antipyretic agents （18 cases） and Chinese patent medicines （16 cases）. Urticaria is mainly caused by quinolones （10 case） . Fixed drug eruption is mainly caused by sulfonamides （28 cases） and analgesic-antipyretic drugs （22 cases）. All the patients fully recovered after receiving antihistamines, corticosteroids and symptomatic and supportiv