摘要
目的 初步评价抗癫痫药物的安全性,并探讨抗癫痫药物引发药疹的防治策略。方法 回顾性分析医院神经内科或儿科2016年1月至2022年12月收治的经皮肤科会诊确诊为由抗癫痫药物致药疹的15例住院患者的临床资料,总结常见引发药疹的抗癫痫药物种类、药疹的分型、系统受累情况、药疹治疗方法的选择和预后。结果 15例患者中,最常引发药疹的药物为奥卡西平(6/15);药疹分型中以麻疹型最常见(13/15),2例Stevens-Johnson综合征(SJS)型分别由奥卡西平和苯巴比妥引起;除药疹外,患者常合并肝功能异常(8/15)、发热(7/15)和外周血嗜酸性粒细胞水平升高(6/15)。经停用/更换致敏抗癫痫药物、抗过敏等对症治疗后,药疹完全消退、系统损害恢复正常。结论 多种抗癫痫药物均可引发药疹,抗癫痫药物引发的药疹以麻疹型多见,但应警惕SJS型的出现及肝功能损害。及时停用致敏药物并更换抗癫痫药物的种类,使用糖皮质激素和(或)抗组胺药物对症治疗,对抗癫痫药物引发的药疹疗效较好。
Objective To preliminarily evaluate the safety of antiepileptic drugs,and to investigate the prevention and treatment strategies for drug eruptions caused by antiepileptic drugs.Methods A retrospective analysis was conducted on the clinical data of 15 inpatients diagnosed with drug eruptions caused by antiepileptic drugs during dermatology consultations in the neurology or pediatrics departments of the hospital from January 2016 to December 2022.The common types of antiepileptic drugs that caused drug eruptions,types of drug eruptions,systemic involvement of drug eruptions,selection of treatment methods of drug eruptions,and prognosis of drug eruptions were summarized.Results Among the antiepileptic drugs for the treatment of 15 inpatients,oxcarbazepine was the most common drug causing drug eruptions(6/15).Among the drug eruption subtypes,maculopapular eruption was the most common(13/15),and two cases of Stevens-Johnson syndrome(SJS)were caused by oxcarbazepine and phenobarbital,respectively.In addition to drug eruptions,patients often had liver dysfunction(8/15),fever(7/15),and elevated peripheral blood eosinophils(6/15).After symptomatic treatment such as discontinuation/replacement of sensitizing antiepileptic drugs and anti-allergy treatment,the drug eruptions completely subsided in all inpatients and the systemic damage returned to normal.Conclusion A variety of antiepileptic drugs can cause drug eruptions.Maculopapular eruptions are the most common type of eruptions caused by antiepileptic drugs,but clinicians should be alert to the presence of the SJS type and drug-induced liver damage.Timely discontinuation of sensitizing drugs,replacement of the type of antiepileptic drugs,and symptomatic treatment with glucocorticoids and/or antihistamines are effective in the treatment of drug eruptions caused by antiepileptic drugs.
作者
陈慧
张青霞
张艺丹
林于樱
赵琛
赵宇
朱威
CHEN Hui;ZHANG Qingxia;ZHANG Yidan;LIN Yuying;ZHAO Chen;ZHAO Yu;ZHU Wei(Xuanwu Hospital,Capital Medical University,Beijing,China 100053)
出处
《中国药业》
CAS
2024年第1期124-128,共5页
China Pharmaceuticals
基金
国家重点研发计划资助课题[2020YFC2008305]。
关键词
抗癫痫药物
药疹
临床表现
防治策略
antiepileptic drugs
drug eruption
clinical manifestations
prevention and treatment strategies
