摘要
目的分析药物过敏反应死亡的危险因素,为临床安全用药提供参考。方法以"药物不良反应""过敏反应""个案报道""过敏性休克"等为检索词,检索中国知网(CNKI)、万方数据库、维普数据库,检索时段为2010年1月1日至2021年10月31日。结果共纳入符合标准文献393篇,涉及病例433例,患者多合并呼吸系统疾病(占30.7%),抗菌药物是引发药物过敏反应最常见的因素(占25.9%),其次是中成药及中药注射剂(占17.6%)。过敏史不详的患者发生药物过敏反应死亡的风险显著增加[OR=5.179,95%CI(2.585~10.376),P<0.001];抗菌药物[OR=2.173,95%CI(1.079~4.377),P=0.030]和放射造影剂[OR=7.014,95%CI(2.619~18.784),P<0.001]是发生过敏性死亡的高危药物。死亡患者86例(占19.9%),过敏性休克是主要死因(占70.9%)。结论过敏性休克是药物过敏反应死亡的主要病因。过敏史不详、使用抗菌药物及放射造影剂是发生药物过敏反应死亡的危险因素,用药前应仔细询问患者过敏史,使用该类药物过程中应加强用药监测。
Objective To analyze the demographocs,causative drugs,route of administration,outcomes,and the risk factors of death caused by allergic reaction.In order to provide reference for clinical safe medication in the future.Methods The case reports published in China Knowledge Network,WanFang Data Service Platform and Weipu.com were searched by computer with“Adverse drug reactions”“Allergic reaction”“Case report”“Anaphylactic shock”as keywords,the database was searched from January 1,2010 to October 31,2021.Res22:562022/3/3ults A total of 433 patients were included in 393 literstures.Most of the patients were complicated with respiratory diseases(30.7%),antibiotics were the main cause of allergic reaction(25.9%),followed by traditional Chinese medicine(17.6%).Patients with unknown allergic history had a significantly increased risk of death from drug-induced allergic reaction[OR=5.179,95%CI(2.585-10.376),P<0.001].Antibiotics[OR=2.173,95%CI(1.079-4.377),P=0.030]and radiocontrast agents[OR=7.014,95%CI(2.619-18.784),P<0.001]were high-risk drugs for allergic death.A total of 86 patients were died(19.9%),and the main cause of death was allergic shock(70.9%).Conclusion Allergic shock was the main cause of death from drug-induced allergy.The risk of death is significantly increased in patients with unknown allergic history,using of antibiotics and radiocontrast agents.So it is important to inquire patients’allergic history before medication carefully and strengthen medication monitoring to ensure medication safety.
作者
王瑛琦
汤春艳
汪小海
葛卫红
WANG Yingqi;TANG Chunyan;WANG Xiaohai;GE Weihong(Department of Anesthesiology,Nanjing Drum Tower Hospital Affiliated to Medical College,Nanjing University,Nanjing 210008,China;Department of Pharmacy,Nanjing Drum Tower Hospital Affiliated to Medical College,Nanjing University,Nanjing 210008,China)
出处
《医药导报》
CAS
北大核心
2022年第3期338-343,共6页
Herald of Medicine
关键词
药物过敏反应
病例报道
文献分析
Drugs-induced allergic reaction
Case reports
Literature analysis
