The Clinical Analysis Of 419 Inpatients Of Drug Eruption

Objective: To analyze the clinical data of 419 cases of hospitalized patients with drug eruption.Summarize the allergenic drugs,clinical features,general rule of the development and laboratory examination for drug eruption,to provide the prevention and treatment of drug eruption.Methods:Statistics and record the clinical data of hospitalized patients with drug eruption in our hospital from June 1999 to October 2016.Analysis the sex,age,latent period,allergenic drugs,types,systemic damage,laboratory examination,therapy of patients with Excel 2003 software.Result:We summarized 419 inpatients with drug eruption,including 232 males and187 females,the ratio of male to female was 1.2: 1.The largest percentage of total number was from30 to 59(58.23%),mean age was(45.27±18.26 years).Among 29 severe drug eruption patients,sex ratio was 1.64:1.419 cases of drug eruption patients,259 of 419 cases of drug eruption patients caused by a sensitization drugs.The major group of drugs causing drug eruption in our study was antibioties(cephalosporin 27.80%,penicillins22.39%),followed by the antipyretic analgesies(13.51%),anti gout drugs(6.17%).The commonest type of drug eruption was morbilliform exanthesis(197/419,47.01%),followed by urticaria(115/419,27.45%),fixed drug eruption(44/419,10.50%).The top three allergenic drugs that caused severe drug eruption were antibioties(41.37%)? antipyretic analgesies(24.13%)and Chinese medicine(17.24%).In this study we found there were 11 cases were erythema multiforme(2.63%),which was the highest rat type among 29 patients with severe drug eruption.In the same time,9 cases of patients were belong to exfoliative dermatitis(2.15%),8 cases were toxic epidermal necrolysis(1.90%).Only 1patient was drug hypersensitivity syndrome(0.24%),whose rate was the lowest amongall the 29 patients laboratory examination.Laboratory examination: Among 419 cases there were 201 cases with blood abnormalities.Of the 176 patients with mild type of drug eruption,the number of white blood cells increased by 81 cases(46.02%),the percentage of neutrophils abnormalities in 104 cases(59.09%);Among 29 cases of severe drug eruption:leukocytosis in 19 cases(64.51%).419 cases of patients with abnormal liver function in 98 cases(23.38%),67 cases(15.99%)of abnormal renal function.In our study,the frist step of therapy was stopping suspicious sensitization drugs,increaseing water quantity or intravenous rehydration.Patients with mild type of drug eruption can be improved after discontinuation of sensitization drugs and glucocorticoids can also be used when necessary.When the condition is stable,skin lesions significantly improved,the steroids gradually slow down.Early and adequate use of glucocorticoid is the key to successful treatment of severe drug eruption.The therapeutic effects of 10 severe drug eruption were dissatisfied,who were treated with glucocorticoid therapy only,then immunoglobulin was applied at the same time to improve efficacy of therapy.The general dose of intravenous immunoglobulin was 0.4g/kg·d for 4 days or so.Conclusion: There was no statistically significant difference between men and women.The highest number of cases was seen between age group of 30 to 59.Common sensitized drugs for the top three antibiotics,antipyretic analgesic and anti-gout drugs.Cephalosporin was the most common drug in the antibioties.The commonest clinical type was morbilliform exanthesis.We found that hepatitis was one of the most common complication,which was more noticeable in patients with severe drug eruption.Drugs which were suspected of highly allergenic should be weaned over immediately,at the same time enough water or intravenous fluids should be applied to accelerate the excretion of toxic drugs.Adequate and early use of glucocorticoid is the key to control the condition of patients with severe drug eruption,use of large amount of immunoglobulin combined with high-dose intravenous methylprednisolone is the most efficient ways for the treatment of patients with severe drug eruption.The combination can reduce the immune response andthe incidence of infection,thereby improving the survival rate of patients.