印度人群中的药物性过敏反应：一项系统评价。

Drug-induced anaphylactic reactions in Indian population: A systematic review.

作者信息

Patel Tejas K, Patel Parvati B, Barvaliya Manish J, Tripathi C B

机构信息

Department of Pharmacology, GMERS Medical College, Gotri, Vadodara, India.

Department of Pharmacology, Government Medical College, Bhavnagar, Gujarat, India.

出版信息

Indian J Crit Care Med. 2014 Dec;18(12):796-806. doi: 10.4103/0972-5229.146313.

DOI:10.4103/0972-5229.146313

PMID:25538414

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4271279/

Abstract

BACKGROUND

Epidemiological data on drug-induced anaphylactic reactions are limited in India and are largely depending on studies from developed countries.

AIM

The aim was to analyze the published studies of drug-induced anaphylaxis reported from India in relation with causative drugs and other clinical characteristics.

MATERIALS AND METHODS

The electronic databases were searched for Indian publications from 1998 to 2013 describing anaphylactic reactions. The information was collected for demographics, set up in which anaphylaxis occurred, causative drugs, incubation period, clinical features, associated allergic conditions, past reactions, co-morbid conditions, skin testing, IgE assays, therapeutic intervention and mortality. Reactions were analyzed for severity, causality, and preventability. Data were extracted and summarized by absolute numbers, mean (95% confidence interval [CI]), percentages and odds ratio (OR) (95% CI).

RESULTS

From 3839 retrieved references, 52 references describing 54 reactions were included. The mean age was 35.31 (95% CI: 30.52-40.10) years. Total female patients were 61.11%. Majority reactions were developed in perioperative conditions (53.70%), ward (20.37%) and home (11.11%). The major incriminated groups were antimicrobials (18.52%), nonsteroidal antiinflammatory drugs-(NSAIDs) (12.96%) and neuromuscular blockers (12.96%). Common causative drugs were diclofenac (11.11%), atracurium (7.41%) and β-lactams (5.96%). Cardiovascular (98.15%) and respiratory (81.48%) symptoms dominated the presentation. Skin tests and IgE assays were performed in 37.03% and 18.52% cases, respectively. The fatal cases were associated with complications (OR =5.04; 95% CI: 1.41-17.92), cerebral hypoxic damage (OR =6.80; 95% CI: 2.14-21.58) and preventable reactions (OR =14.33; 95% CI: 2.33-87.97).

CONCLUSION

Antimicrobials, NSAIDs, and neuromuscular blockers are common causative groups. The most fatal cases can be prevented by avoiding allergen drugs.

摘要

背景

在印度，关于药物引起的过敏反应的流行病学数据有限，且很大程度上依赖于发达国家的研究。

目的

分析印度已发表的关于药物引起的过敏反应的研究，涉及致病药物和其他临床特征。

材料与方法

在电子数据库中搜索1998年至2013年期间描述过敏反应的印度出版物。收集人口统计学信息、过敏反应发生的环境、致病药物、潜伏期、临床特征、相关过敏状况、既往反应、合并疾病、皮肤试验、免疫球蛋白E检测、治疗干预和死亡率等信息。对反应的严重程度、因果关系和可预防性进行分析。数据通过绝对数、均值（95%置信区间[CI]）、百分比和比值比（OR）（95%CI）进行提取和汇总。

结果

从检索到的3839篇参考文献中，纳入了52篇描述54例反应的参考文献。平均年龄为35.31岁（95%CI：30.52 - 40.10）。女性患者占61.11%。大多数反应发生在围手术期（53.70%）、病房（20.37%）和家中（11.11%）。主要的致病药物类别为抗菌药物（18.52%）、非甾体抗炎药（NSAIDs）（12.96%）和神经肌肉阻滞剂（12.96%）。常见的致病药物有双氯芬酸（11.11%）、阿曲库铵（7.41%）和β-内酰胺类（5.96%）。心血管症状（98.15%）和呼吸道症状（81.48%）是主要表现。分别有37.03%和18.52%的病例进行了皮肤试验和免疫球蛋白E检测。致命病例与并发症（OR = 5.04；95%CI：1.41 - 17.92）、脑缺氧损伤（OR = 6.80；95%CI：2.14 - 21.58）和可预防性反应（OR = 14.33；95%CI：2.33 - 87.97）相关。