| Objective(s):A retrospective study was conducted on the allergic drug characteristics,clinical features and hospitalization costs of hospitalized dermatological patients with drug eruption from 2016 to 2018.To provide scientific basis for strengthening the awareness of rational drug use and the prevention and treatment of adverse drug reactions.Methods:Collect the information about the patient diagnosticed drug eruption from the department of dermatology of grade a class three hospital of Yunnan province from 2016 to 2018 by cluster sampling method,include the patients' gender,age,type of drug eruption,hospitalized time,reasons of drug use,the type and quantity of sensitizing drugs,open mode,method of administration,past medical history and history of allergies,mucosal involvement,accompanying symptoms and signs,auxiliary examinations,glucocorticoid and other treatments,complications,,hospitalization days,hospitalization cost etc,that the above information could be divided into benign drug eruption group and severe drug eruption group,and furthermore divided into<30 years old group,31-60 years old group,and 61-90 years old group to analyze.EXCEL software was used to collect data and SPSS software was used for statistical analysis.Results:1.372 cases of drug eruption mainly occurred in people aged 21-70 years,and 46.0%were 31-60 years old.43.3%for males and 56.7%for females.There was no significant difference in age and gender between the benign and severe drug eruption groups.2.Benign and severe drug eruptions were accounted for 73.1%and 26.9%.The most common type of the Benign and severe drug eruptions were exanthematous eruption(54%)and SJS(41%).There was no seasonal difference in the distribution of benign or severe drug eruption.3.Upper respiratory tract infection(33.6%)was the main cause of drug use,12.1%was caused by diseases of the skin and mucous membrane system,and 7.5%was caused by neuropsychiatric diseases.The top three suspected sensitizing drugs were Chinese medicine(57.4%);Antibiotics(49.3%);Non-steroidal anti-inflammatory drugs(18.3%).35.2%of the patients were sensitized to single drug use,and 48.1%used more than one drug.Among all the sensitizing drugs,40.1%were self-administered.The benign group was mainly used by self-medication,while the severe group was mainly used by non-specialists(P<0.017).35.2%were sensitized by single drug use,48.1%were sensitized by more than one drug use,and the majority of patients in the severe drug eruption group were sensitized by multiple drugs(P<0.05).Both benign and severe drug eruption groups were mainly used orally.The majority of traditional Chinese medicin was Chinese patent medicine(50.6%)and mainly used by self-medication(50.6%).The majority of antibiotics was?-lactam antibiotics(62.7%)and mainly opened by non-specialists(44%).The majority of non-steroid anti-inflammatory drug was aminophenazone(38.2%)and opened mainly by self-administered(66.2%).4.The hospitalization days and expenses of the benign drug eruption group were 8.0(7.0,10.0)days and 4009.2(3374.2,5149.9)yuan,that of the severe drug eruption group were 10.0(8.0,14.0)days and 6490.8(4418.7,8475.0)yuan.The sesevre drug eruption group had longer hospital stay and more hospital expenses than begnin group(P<0.05).5.Mucosal involvement,accompanying symptoms and signs,and ECG abnormalities in the severe drug eruption group were more than those in the benign drug eruption group(P<0.05).The percentage of neutrophils,positive rate of urine protein,fasting blood glucose and sodium ion concentration in the severe drug eruption group were higher than those in the benign drug eruption group(P<0.05).However,the absolute value of eosinophil,percentage of eosinophil,Lymphocyte percentage,lymphopenia,hemoglobin,erythrocyte,albumin,indirect bilirubin,calcium ion and chloride ion concentrations were lower than those of the benign drug eruption group(P<0.05).Among the 372 patients,73 cases were detected by EBV-DNA test,and 40 cases were detected by CMV-DNA test.And the positive rates of EBV-DNA in the benign and severe drug eruption groups were 25.8%and 45.2%,and the positive rates of CMV-DNA were 7.1%and 3.8%,respe.There was no statistically significant difference in viral infection rate between the two groups.6.The number of patients with severe drug eruption combined with leukopenia,anemia,hypoproteinemia,abnormal liver function,abnormal renal function,increased fasting blood glucose,and electrolyte disturbance was higher than that of the benign drug eruption group(P<0.05).In the benign group,53.3%of the patients had a previous medical history,and 62%of the patients in the severe group had a previous medical history,all of which were dominated by cardiovascular diseases.There were more cases of autoimmune disease and neuropsychiatric disease in the severe drug eruption group than in the benign drug eruption group(P<0.05).7.The dose of glucocorticoid in the severe drug eruption group was higher than that in the benign drug eruption group(P<0.05).The use rate of antihistamine in the benign drug eruption group was higher than that in the severe drug eruption group(P<0.05).8.There was no significant difference in the distribution of drug eruption types in the<30 years old group,the 31-60 years old group,and the 61-90 years old group.The proportion of women in the<30 years old group was higher than that in the 31-60 years old group(P<0.017).More patients in the benign drug eruption group aged 31-60 years were treated with drugs for skin mucosal diseases than those in the 61-90 years old group(P<0.017).In the group of 31-60 years old,the number of patients with thyroid disease and hypoproteinemia was higher than that in the group of<30 years old(P<0.017).There were more cases of hypertension and hypoproteinemia in the group of 61-90 years old than in the group of<30 years old.In the severe drug eruption,the group of<30 years old and the group of 31-60 years old were more susceptible to antibiotic use than the group of 61-90 years old(P<0.017).The number of patients with hypertension in the 31-60 years old group and the 61-90 years old group was higher than that in the<30 years old group(P<0.017).The patients with abnormal renal function in the 61-90 years old group were more than those in the<30 years old group(P<0.017)Conclusion(s):1.The most common benign drug eruption is exanthematous eruption,the most common severe drug eruption is Stevens-Johnson Syndrome.2.The most common cause of drug use is upper respiratory tract infection,and severe drug eruption is more sensitized to neuropsychiatric drug use than benign drug eruption.3.The top three allergenic drugs are traditional Chinese medicine,antibiotics and non-steroidal anti-inflammatory drugs.4.Non-steroidal anti-inflammatory drugs are more likely to cause benign drug eruptions,and anti-epileptic drugs(mainly carbamazepine)are more likely to cause severe drug eruptions.4.Severe drug eruptions are commonly sensitized by multiple use,and are mostly prescribed by non-specialist doctors;benign drug eruption is a common drug sensitization condition,and are mainly self-administered.5.The prescription of Traditional Chinese medicine is mainly self-administered,and the the most common sensitizing drug is Chinese patent medicine;antibiotics is mainly prescribed by non-specialist,and the the most common sensitizing drug is ?-lactam antibiotics,Non-steroidal anti-inflammatory drugs are mainly prescribed by self-administration,and the most common sensitizing drug is Aminophenazone.6.Severe drug eruptions have more visceral involvement than the benign drug eruptions.More than half of the cases have a basic medical history,which mainly is cardiovascular system disease(mainly hypertension).7.Pay attention to the management of hypoproteinemia in patients older than 30 years old in the treatment of benign drug eruption,and watch out for renal abnormalities in patients aged from 61 to 90 years old in the treatment of severe drug eruption.Attention should be paid to the management of hypertension in all cases and the awareness of rational drug use should be raised in the patients with hypertension.Expand virus detection rate,and treat the virus infection actively. |
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