Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, Fujian, China.
Department of Dermatology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
J Immunol Res. 2018 Feb 11;2018:4320195. doi: 10.1155/2018/4320195. eCollection 2018.
Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are life-threatening disease. However, there are only few epidemiologic studies of SJS/TEN from China. To analyze the clinical characteristics, causality, and outcome of treatment for SJS/TEN in China, we reviewed case reports of patients with SJS/TEN from the China National Knowledge Infrastructure (CNKI) and Wanfang database from 2006 to 2016 and patients with SJS/TEN who were admitted to the First Affiliated Hospital of Fujian Medical University during the same period. There were 166 patients enrolled, including 70 SJS, 2 SJS/TEN overlap, and 94 TEN. The most common offending drugs were antibiotics (29.5%) and anticonvulsants (24.1%). Carbamazepine, allopurinol, and penicillins were the most common single offending drugs (17.5%, 9.6%, and 7.2%). Chinese patent medicines accounted for 5.4%. There were 76 (45.8%) patients receiving systemic steroid and intravenous immunoglobulin (IVIG) in combination therapy, especially for TEN (80.3%), and others were treated with systemic steroids alone. Mortality rate of combination treatment comparing with steroid alone in TEN patients had no statistical significance. In conclusion, carbamazepine and allopurinol were the leading causative drugs for SJS/TEN in China. Combination of IVIG and steroids is a common treatment for TEN, but its efficacy in improving mortality needs further investigation.
史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症(SJS/TEN)是危及生命的疾病。然而,来自中国的 SJS/TEN 仅有少数流行病学研究。为了分析中国 SJS/TEN 的临床特征、病因和治疗结果,我们回顾了 2006 年至 2016 年期间中国国家知识基础设施(CNKI)和万方数据库中 SJS/TEN 病例报告和同期福建医科大学第一附属医院 SJS/TEN 住院患者。共纳入 166 例患者,其中 SJS 70 例,SJS/TEN 重叠 2 例,TEN94 例。最常见的致病药物为抗生素(29.5%)和抗惊厥药(24.1%)。卡马西平、别嘌呤醇和青霉素为最常见的单一致病药物(17.5%、9.6%和 7.2%)。中成药占 5.4%。76 例(45.8%)患者接受了包括静脉注射免疫球蛋白(IVIG)和全身类固醇在内的联合治疗,特别是 TEN(80.3%),其他患者接受了全身类固醇单独治疗。与 TEN 患者单独使用类固醇相比,联合治疗的死亡率无统计学意义。总之,卡马西平和别嘌呤醇是中国 SJS/TEN 的主要致病药物。IVIG 和类固醇的联合治疗是 TEN 的常用治疗方法,但改善死亡率的疗效需要进一步研究。
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