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抗结核治疗过程中伴外周血嗜酸性粒细胞增多的患者的皮肤药物不良反应。

Cutaneous adverse drug reactions in patients with peripheral blood eosinophilia during antituberculosis treatment.

机构信息

Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.

出版信息

Korean J Intern Med. 2019 Sep;34(5):1050-1057. doi: 10.3904/kjim.2018.063. Epub 2019 Mar 19.

Abstract

BACKGROUND/AIMS: Peripheral eosinophilia during tuberculosis (TB) treatment is common, but has not been fully evaluated. The aim of this study was to determine the prevalence and clinical significance of peripheral blood eosinophilia in patients undergoing anti-TB treatment.

METHODS

We retrospectively reviewed the clinical and laboratory data of patients who received anti-TB treatment and had peripheral blood eosinophilia (> 5% of the total white blood cell count) at the Chonnam National University Hospital between January 2010 and December 2014.

RESULTS

Of all 2,234 patients with TB who received anti-TB treatment, 397 (17.8%) had peripheral blood eosinophilia. Of the 397 with eosinophilia, we reviewed the data of 262 (66%), and cutaneous adverse drug reactions (CADRs) were observed in 161 (61.5%). Of the 161 with CADRs, itching (47.2%) and skin rash (47.8%) were common. Older age, abnormal liver function, and higher peak blood eosinophil percentage were associated with CADRs in multivariate analysis. There was a significant relationship between increased peak eosinophil counts and the degree of severity of CADRs.

CONCLUSION

Peripheral blood eosinophilia is a relatively common occurrence during anti-TB treatment. Peripheral blood eosinophil counts were higher according to the degree of severity of CADRs.

摘要

背景/目的:在结核病(TB)治疗期间外周血嗜酸性粒细胞增多很常见,但尚未得到充分评估。本研究旨在确定接受抗结核治疗的患者外周血嗜酸性粒细胞增多(外周血白细胞总数的>5%)的患病率和临床意义。

方法

我们回顾性分析了 2010 年 1 月至 2014 年 12 月期间在全南国立大学医院接受抗结核治疗且外周血嗜酸性粒细胞增多(>5%的外周血白细胞总数)的患者的临床和实验室数据。

结果

在接受抗结核治疗的 2234 例结核病患者中,有 397 例(17.8%)出现外周血嗜酸性粒细胞增多。在 397 例嗜酸性粒细胞增多的患者中,我们回顾了 262 例(66%)的数据,观察到 161 例(61.5%)出现药物性皮肤不良反应(CADR)。在 161 例 CADR 中,瘙痒(47.2%)和皮疹(47.8%)很常见。多变量分析显示,年龄较大、肝功能异常和较高的嗜酸性粒细胞百分比峰值与 CADR 相关。嗜酸性粒细胞计数的增加与 CADR 的严重程度之间存在显著关系。

结论

在抗结核治疗期间外周血嗜酸性粒细胞增多是一种相对常见的现象。外周血嗜酸性粒细胞计数根据 CADR 的严重程度而升高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd93/6718751/2238118ebd2f/kjim-2018-063f1.jpg

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