250例可疑糖皮质激素过敏患者的临床特征回顾及典型案例分析

郭娟; 皮强中; 戴晓天

doi:10.6039/j.issn.1001-0408.2025.03.15

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250例可疑糖皮质激素过敏患者的临床特征回顾及典型案例分析

药物与临床 | 更新时间：2025-02-10

- 250例可疑糖皮质激素过敏患者的临床特征回顾及典型案例分析
- Retrospective review of clinical characteristics in 250 cases of suspected glucocorticoid allergy and typical case analysis
- 中国药房 2025年36卷第3期页码：346-350
- 作者机构：
  
  陆军军医大学第一附属医院呼吸与危重症医学科，重庆　400038
- 作者简介：
  
  住院医师，硕士。研究方向：糖皮质激素过敏的诊治。E-mail：1142193627@qq.com
  副主任医师，副教授，硕士生导师，博士。研究方向：慢性气道疾病及相关感染的诊治。E-mail：daixiaot@tmmu.edu.cn
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2025.03.15
  中图分类号： R977.1+1;R969.3
- 纸质出版日期：2025-02-15，
  
  收稿日期：2024-11-14，
  
  修回日期：2025-01-11，
  
  录用日期：2025-01-13
- 稿件说明：
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郭娟,皮强中,戴晓天.250例可疑糖皮质激素过敏患者的临床特征回顾及典型案例分析[J].中国药房,2025,36(03):346-350.

GUO Juan,PI Qiangzhong,DAI Xiaotian.Retrospective review of clinical characteristics in 250 cases of suspected glucocorticoid allergy and typical case analysis[J].ZHONGGUO YAOFANG,2025,36(03):346-350.
郭娟,皮强中,戴晓天.250例可疑糖皮质激素过敏患者的临床特征回顾及典型案例分析[J].中国药房,2025,36(03):346-350. DOI： 10.6039/j.issn.1001-0408.2025.03.15.

GUO Juan,PI Qiangzhong,DAI Xiaotian.Retrospective review of clinical characteristics in 250 cases of suspected glucocorticoid allergy and typical case analysis[J].ZHONGGUO YAOFANG,2025,36(03):346-350. DOI： 10.6039/j.issn.1001-0408.2025.03.15.

摘要

目的

探讨糖皮质激素过敏患者的临床特征，并为合并支气管哮喘的患者提供治疗及预防策略。

方法

回顾性分析2002年5月1日至2022年4月30日陆军军医大学第一附属医院（以下简称“我院”）全院收治的250例可疑糖皮质激素过敏患者的临床资料，并进行典型案例分析。

结果

250例可疑糖皮质激素过敏患者中，女性患者140例（56.00%），男性患者110例（44.00%）。入院科室以内科为主（118例，47.20%）。170例患者（68.00%）对地塞米松过敏，37例（14.80%）对泼尼松过敏。238例患者（95.20%）对1种糖皮质激素过敏，12例（4.80%）对2种糖皮质激素过敏。明确记录糖皮质激素使用途径者10例，其中静脉使用6例，口服4例。250例患者中，仅有32例明确记录了糖皮质激素过敏的临床表现，临床表现多见皮疹（12例）、皮肤瘙痒（8例），有6例患者同时伴有皮疹及皮肤瘙痒。糖皮质激素过敏的治疗以停药及对症治疗为主；对于合并支气管哮喘的患者，在其后续治疗中基本需要更换其他糖皮质激素以控制病情。我院可疑糖皮质激素过敏住院发生率为0.019%；可疑糖皮质激素过敏合并支气管哮喘发生率为0.201%。此外，我院1例支气管哮喘合并慢性阻塞性肺疾病患者发生糖皮质激素过敏案例，经综合分析考虑糖皮质激素（甲泼尼龙片、醋酸地塞米松片）过敏，且抗组胺治疗有效。

结论

糖皮质激素过敏临床罕见，其临床表现多以皮疹、皮肤瘙痒等轻度反应为主。支气管哮喘患者如发生糖皮质激素过敏，其治疗包括更换其他糖皮质激素、改变糖皮质激素使用途径、对症治疗、应用免疫抑制剂辅助或替代治疗等。

Abstract

OBJECTIVE

To investigate the clinical characteristics of glucocorticoid allergy， and provide treatment and prevention strategies for patients with concurrent bronchial asthma.

METHODS

A retrospective analysis was conducted on the clinical data of 250 patients with suspected glucocorticoid allergy admitted to the First Affiliated Hospital of Army Medical University （hereinafter referred to as “our hospital”）from May 1st， 2002， to April 30th， 2022； and a typical case analysis was carried out.

RESULTS

Among 250 patients with suspected glucocorticoid allergy， 140 were female patients （56.00%） and 110 were male patients （44.00%）. The majority of admissions were to the internal medicine department （118 cases， 47.20%）. One hundred and seventy patients （68.00%） were allergic to dexamethasone， and 37 patients （14.80%） were allergic to prednisone. Two hundred and thirty-eight patients （95.20%） were allergic to one type of glucocorticoid， and 12 patients （4.80%） were allergic to two types of glucocorticoid. Ten patients had clear records of glucocorticoid administration routes， in which 6 were intravenous and 4 were oral. Among the 250 patients， only 32 cases had clear records of clinical manifestations of glucocorticoid allergy， the most common clinical manifestations were rash （12 cases） and skin itching （8 cases）， with 6 patients experiencing both rash and skin itching. The treatment for glucocorticoid allergy mainly involved discontinuing the medication and providing symptomatic treatment. For patients with concurrent bronchial asthma， it was generally necessary to switch to other glucocorticoids in their subsequent treatment to control the condition. The incidence of suspected glucocorticoid allergy among inpatients in our hospital during the same period was 0.019%. The incidence of suspected glucocorticoid allergy with concurrent bronchial asthma was 0.201%. Additionally， a case analysis of bronchial asthma combined with chronic obstructive pulmonary disease in our hospital resulted in glucocorticoid allergy revealed that， based on the patient’s medical history and drug challenge test results， the patient was diagnosed with glucocorticoid （Methylprednisolone tablets and Dexamethasone acetate tablets） allergy， and antihistamine treatment was effective.

CONCLUSIONS

Glucocorticoid allergy is clinically rare， and its clinical manifestations are predominantly mild reactions such as rashes and skin itching. For patients with concurrent bronchial asthma who experience glucocorticoid allergy， treatment options include switching to other glucocorticoids， altering the route of glucocorticoid administration， symptomatic treatment， and the use of immunosuppressive agents as adjunctive or alternative therapy.

关键词

糖皮质激素过敏反应支气管哮喘地塞米松临床特征

Keywords

allergybronchial asthmadexamethasoneclinical characteristics

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