结核病与肺部健康杂志 ›› 2017, Vol. 6 ›› Issue (3): 293-281.doi: 10.3969/j.issn.2095-3755.2017.03.000

• 综述 • 上一篇    下一篇

抗结核药物诱导的药物超敏反应综合征研究进展

杨松,严晓峰   

  1. 400036 重庆市公共卫生医疗救治中心
  • 收稿日期:2017-03-29 出版日期:2017-09-30 发布日期:2017-09-30
  • 作者简介:杨松

Study progress on anti-tuberculosis drug-induced hypersensitivity syndrome

YANG Song, YAN Xiao-feng   

  1. Chongqing Infectious Disease Medical Center, Chongqing 400036, China
  • Received:2017-03-29 Online:2017-09-30 Published:2017-09-30

摘要: 药物超敏反应综合征(drug induced hypersensitivity syndrome,DIHS)是一种严重威胁生命的药物不良反应,是对药物产生的一种严重超敏反应,表现为皮疹、发热、淋巴结肿大、血液学异常(嗜酸粒细胞增多症和非典型的淋巴细胞增多)和内脏器官受损。磺胺类、苯巴比妥、柳氮磺吡啶、卡马西平、苯妥英钠、二甲双胍、别嘌呤醇、丙戊酸钠、米诺环素等药物均可导致DIHS;此外,抗结核药物诱导的DIHS也非常严重,可威胁患者生命。但是关于该病的特点和遗传危险因子仍不完全明确,皮疹和侵犯脏器的多样性致使DIHS的诊断面临挑战,DIHS的治疗主要是剔除可疑药物和使用糖皮质激素治疗。作者拟对DIHS的发病机制和诊治进展进行综述,以提高对DIHS的认识和诊治水平。

Abstract: Drug-induced hypersensitivity syndrome (DIHS) is a potentially life-threatening adverse drug reaction. DIHS reflects a serious hypersensitivity reaction to drugs, characterized by skin rash, fever, lymph node enlargement, hematologic abnormalities (eosinophilia or increase of atypical lymphocytes) and damages of internal organs. So far, numerous drugs, such as sulfonamides, phenobarbital, sulfasalazine, carbamazepine, phenytoin, melbine, allopurinol, sodium valproate, minocycline, etc., have been reported to cause the DIHS. The anti-tuberculosis (anti-TB) drugs can also cause this potentially fatal syndrome and the anti-TB drug-induced hypersensitivity syndrome is considered to be a serious adverse reaction too. However, it remains much unclear regarding its characteristics and genetic risk factors. The diagnosis of DIHS is facing challenges because the pattern of cutaneous eruption and the type of organ damages are various. The treatment for DIHS is to stop using the culprit drugs and give corticosteroids. In this study, in order to increase the awareness of DIHS and improve the level of diagnosis and treatment of this disease, a literature review was done to elaborate the study progress on the pathogenesis, clinical manifestations, diagnosis and management of DIHS.