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目的了解北京大学第三医院药源性过敏性休克(DIAS)和严重过敏样反应(DIAR)的致敏药物类型及过敏反应的发生情况(包括临床表现、救治方案及预后等)。方法筛选北京大学第三医院2004-01-01—2014-12-31上报国家药品不良反应监测系统的DIAS和DIAR报告,对纳入报告患者的一般情况、致敏药物类型、临床表现、治疗方案及转归等资料进行分析。结果共纳入69份不良反应报告,男女比例为1.00∶1.56,以速发型超敏反应为主(85.5%),最常见的致敏药物为抗菌药物(45.5%),临床症状主要表现为心血管系统(92.8%)、呼吸系统(58.0%)和皮肤黏膜系统(58.0%)受累。在DIAS和DIAR救治中,糖皮质激素(58.0%)、补液治疗(53.6%)以及抗过敏药物治疗(40.6%)最为常见。69份不良反应报告中,经救治后痊愈29例(42.0%),好转37例(53.6%),死亡、住院治疗、数据缺失各1例(1.4%)。结论 DIAS与DIAR占全部报告的2.5%(69/2761),由于其存在不可预测性,对患者危害较大,建立规范的救治及预防措施具有重要意义。
Objective To investigate the types of sensitization drugs and the occurrence of allergic reactions (including clinical manifestation, treatment plan and prognosis) in Pesticide-induced Anaphylactic Shock (DIAS) and Severe Anaphylactoid Reaction (DIAR) in Peking University Third Hospital. Methods Screening DIAS and DIAR reports from National Adverse Drug Reaction Monitoring System of Peking University Third Hospital from January 2004 to January 31, 2014, reported the general situation of patients, the type of drug, clinical manifestations, treatment options and Outcome and other data for analysis. Results A total of 69 reports of adverse reactions were included in this study. The ratio of male to female was 1.00: 1.56. The majority were immediate hypersensitivity reactions (85.5%). The most common sensitizing agents were antibiotics (45.5%). The clinical manifestations were mainly cardiovascular System (92.8%), respiratory system (58.0%) and mucocutaneous system (58.0%) were involved. Glucocorticoid (58.0%), rehydration therapy (53.6%), and anti-allergy medication (40.6%) were most common in DIAS and DIAR. Of the 69 ADRs, 29 (42.0%) were cured, 37 (53.6%) were cured, and 1 (1.4%) died, hospitalized, and data were missing. Conclusions DIAS and DIAR account for 2.5% (69/2761) of the total reported. Because of their unpredictability and greater harm to patients, it is of great significance to establish normative treatment and preventive measures.