15 例重症药疹患者临床特征及激素联合免疫球蛋白的疗效分析

目的:探讨15例重症药疹患者的临床特点及采用激素联合免疫球蛋白治疗改病的临床效果。方法:回顾性分析2012年12月至2014年12月在我院就诊的15例重症药疹患者的临床资料,患者采用激素联合免疫球蛋白进行治疗,观察患者的发病类型、致敏药物及疗效,分析血常规、肝功能、肾功能指标与与预后的关系。结果:15例患者中,中毒表皮坏死松解8例,占53.33%,药疹重型4例,占26.67%,中毒表皮坏死松解并支气管炎患者、史蒂文斯并支气管肺炎患者及重症药疹并重症肝炎患者各1例,占6.67%。致敏药物主要是中药、卡马西平、柳氮磺吡啶、头孢他啶、布洛芬、青霉素、别嘌呤醇、感冒药。治疗总有效率86.67%。白细胞、中性比、总胆红素(TBIL)、谷丙转氨酶、胆碱酯酶、胱抑素、肌酐(Cr)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)与重症药疹患者治愈预后有关(P0.05)。结论:重症药疹以中毒表皮坏死松解患者为主,对不同致敏药物引起的重症药疹患者应进行区别治疗,重症药疹患者的预后与患者内脏受累程度密切相关,临床采用激素联合丙种球蛋白持续治疗,可提高治愈率,改善患者临床症状及预后,

Clinical Characteristics of 15 Severe Drug Eruption Patients and the Effect of Hormone Combined with Immune Globulin Treatment

Objective:To investigate the characteristics of 15 severe drug eruption patients and the effect of hormone combined with immune globulin treatment.Methods:Retrospective analyzed the clinical data of 15 severe drug eruption patients in our hospital from December 2012 to December 2014, they were treated with hormone combined with immune globulin. Observed the disease type, sensitization drugs and the treatment effect, and analyzed the relationship of indexes of routine blood test, liver function, renal function with cure prognosis.Results:In 15 patients, there were 8 cases of toxic epidermal necrolysis, accounting for 53.33%, and 4 cases of rash heavy, accounting for 26.67%, and 1 cases of toxic epidermal necrolysis complicated with bronchitis, Steven-Johnson complicated with bronchial pneumonia and severe drug eruption complicated with severe hepatitis, respectively, accounting for 6.67%. Sensitization drugs were mainly traditional Chinese medicine, carbamazepine, Sulfasalazine, ceftazidime, ibuprofen, penicillin, allopurinol, cold medicine. The total effective rate was 86.67%. Leukocyte, neutrocyte radio, total bilirubin(TBIL), alanine aminotransferase, cholinesterase, cystatin and creatinine (Cr), lactate dehydrogenase(LDH), creatine kinase(CK), creatine kinase isoenzyme(CK-MB) were related with the cure prognosis of severe drug eruption patients.Conclusion:Toxic epidermal necrosis patients take the majority in severe drug eruption patients, and the severe drug eruption patients should be treated differently due to the various allergenic drugs, the prognosis is closely related with the degree of visceral involvement, and we could use hormone combined with immune globulin treatment continually to increase the cure rate, and improve the clinical symptoms and prognosis of patients.