126例重症药疹住院患者的临床特征及预后

目的：探讨各型重症药疹的临床特点、常见致敏药物及治疗，为重症药疹的合理防治、减少其并发症、 提高治愈率提供参考。方法：对中南大学湘雅医院2009年6月至2017年5月收治的126例重症药疹的临床资料进行回顾 性分析。结果：126例重症药疹中，男女比例为1:1.38；住院时间为(12.7±9.8) d。最常见类型为重症多形红斑型药疹， 最凶险的类型为大疱性表皮松解型药疹，死亡2例。抗生素为本组患者最常见的致敏药物类别；最常见的单一致敏药 物为卡马西平，其次为别嘌呤醇。结论：本地区重症药疹多见于中青年人群，重症多形红斑型药疹为最常见类型， 大疱性表皮松解型药疹病死率最高，药物超敏反应综合征的住院时间最长。及时停用致敏药物，早期足量应用糖皮 质激素，适时联合使用非激素治疗手段如静脉注射免疫球蛋白(intravenous immunogloblin，IVIG)、血浆置换、血液透 析，有助于提高疗效，降低并发症和病死率。

Clinical characteristics and prognosis for 126 patients with severe drug eruption

Objective: To explore the clinical characteristics of various types of severe drug eruption and common sensitized drugs, and to provide clinical references for reducing the incidence of severe drug eruption. Methods: The clinical data regarding 126 cases of severe drug eruption were analyzed retrospectively from June 2009 to May 2017 in Xiangya Hospital, Central South University. Results: In the 126 cases of severe drug eruption, the distribution of men and women ratio was 1:1.38. The length of stay was (12.7±9.8) d. The most common type was Steven-Johnson syndrome; the most dangerous type was drug-induced bullosa epidermolysis. The most common sensitized drug category in these patients was antibiotics; the most common single sensitizing drug was carbamazepine, following by allopurinol. Conclusion: Severe drug eruption occurs mostly in young and middle-aged people. Steven- Johnson syndrome is the most common type; drug hypersensitive syndrome has the longest length of hospital course. Mortality rate of drug-induced bullosa epidermolysis is the highest. Timely stop using of allergens, early using glucocorticoids, and timely combination of non-glucocorticoids treatment (such as intravenous immunogloblin, plasma exchange and hemodialysis), can improve the efficacy and reduce the complications and mortality.