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[多次使用肾上腺素治疗食物诱发的过敏反应]

[USE OF MULTIPLE DOSES OF ADRENALINE FOR FOOD-INDUCED ANAPHYLAXIS].

作者信息

Araki Mayumi, Hamahata Yuko, Usui Machiko, Akashi Masayuki

机构信息

Keiyu Hospital Pediatrics.

Saitama City Hospital Pediatrics.

出版信息

Arerugi. 2018;67(6):751-758. doi: 10.15036/arerugi.67.751.

Abstract

BACKGROUND

The aim of this study was to determine the rate, characteristics, and risk factors in patients who required multiple doses of adrenaline for treatment of anaphylaxis.

METHODS

We retrospectively reviewed the positive oral food challenges (OFCs) with anaphylaxis in pediatric patients at Saitama City Hospital between January 2013 and November 2014, analyzing age, sex, comorbid allergic disease, specific IgE level, food, symptoms, and treatment.

RESULT

There were 42 positive challenges with anaphylaxis, and the median age of the patients was 4 years old. Eighteen patients were treated with adrenaline, 5 of whom (11.9% of anaphylaxis cases) were administered multiple doses of adrenaline. Among the 5 patients, 3 were treated with infusion. We compared patients who were not administered adrenaline or were administered a single dose of adrenaline with those who were administered multiple doses of adrenaline. No significant differences were found among the groups in relation to age, sex, comorbid allergic disease, and the aim of OFCs. The number of patients who received multiple doses of adrenaline treatment was more in the milk OFCs than the other foods OFCs. Cardiovascular and neurological symptoms were more severe in patients who received multiple doses of adrenaline.

CONCLUSION

Information that multiple doses of adrenaline may be required at the time of anaphylaxis should be widely disseminated.

摘要

背景

本研究旨在确定因过敏反应需要多次注射肾上腺素治疗的患者的发生率、特征和危险因素。

方法

我们回顾性分析了2013年1月至2014年11月在埼玉市立医院儿科患者中因过敏反应进行的阳性口服食物激发试验(OFCs),分析了年龄、性别、合并的过敏性疾病、特异性IgE水平、食物、症状和治疗情况。

结果

共有42例因过敏反应进行的阳性激发试验,患者的中位年龄为4岁。18例患者接受了肾上腺素治疗,其中5例(占过敏反应病例的11.9%)接受了多次肾上腺素注射。在这5例患者中,3例接受了静脉输注治疗。我们将未接受肾上腺素治疗或仅接受单次肾上腺素注射的患者与接受多次肾上腺素注射的患者进行了比较。在年龄、性别、合并的过敏性疾病以及OFCs的目的方面,各组之间未发现显著差异。接受多次肾上腺素治疗的患者在牛奶OFCs中比在其他食物OFCs中更多。接受多次肾上腺素治疗的患者心血管和神经系统症状更严重。

结论

应广泛传播关于过敏反应时可能需要多次注射肾上腺素的信息。

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