目的 探討質(zhì)子泵抑制劑致過敏性休克的規(guī)律及特點,為其臨床合理應用提供依據(jù)。方法 檢索中國知網(wǎng)總庫、萬方數(shù)據(jù)總庫、維普網(wǎng)、中國生物醫(yī)學文獻服務系統(tǒng)和PubMed、Web of Science數(shù)據(jù)庫收錄的1990—2022年間發(fā)表的質(zhì)子泵抑制劑致過敏性休克相關(guān)案例報道文獻,對符合要求的病例進行統(tǒng)計和分析。結(jié)果 共收集到82篇文獻,共計84例質(zhì)子泵抑制劑致過敏性休克。男女比例約為1∶1,以41~60歲和61~80歲患者居多,均占36.47%;具有食物或藥物過敏史者占28.57%;共涉及5種藥物,奧美拉唑、泮托拉唑、蘭索拉唑分別位居前3位,占90.49%;以靜脈方式給藥的發(fā)生率最高,占60.71%;主要發(fā)生于首次用藥,用藥60 min內(nèi),占78.57%,其中最快為用藥后幾秒鐘;主要臨床表現(xiàn)為血壓下降、大汗淋漓、心率加快、皮膚瘙癢、皮疹等;預后良好;不同的質(zhì)子泵抑制劑間可能存在交叉過敏。結(jié)論 多種質(zhì)子泵抑制劑均可引起過敏性休克,應引起廣大醫(yī)務工作者的關(guān)注,加強用藥監(jiān)護,保證患者用藥安全。

Objective To explore the regularity and characteristics of anaphylactic shock induced by proton pump inhibitors, and to provide evidence for their rational clinical application.Methods The relevant case reports of anaphylactic shock caused by proton pump inhibitors published from 1990 to 2022, which were collected by the China National Knowledge Network, the Wanfang database,and the China Biomedical Literature Service System, Pubmed, and Web of Science were retrieved, and make statistics and analysis on the cases that meet the requirements.Results A total of 82 articles were collected, including 84 cases of anaphylactic shock caused by proton pump inhibitors. The proportion of men and women is about 1∶1, with the majority of patients aged from 41 to 60 and from 61 to 80, both accounting for 36.47%; 28.57% patients had a history of food or drug allergy. A total of 5 drugs were involved, with omeprazole, pantoprazole and lansoprazole ranking the top 3, accounting for 90.49%. The incidence of intravenous administration was the highest, accounting for 60.71%, it mainly occurred in the first medication, accounting for 78.57% within 60 min of medication, and the fastest was few seconds after medication. The main clinical manifestations are decreased blood pressure, sweating, increased heart rate, itching, erythra etc. The prognosis is good, cross-hypersensitive reaction between proton pump inhibitors may exist.Conclusion Proton pump inhibitors can cause anaphylactic shock, which should be paid attention to by medical workers, and drug monitoring should be strengthened to ensure drug safety of patients.

R914

吳階平醫(yī)學基金會臨床科研專項(320.6750.2020-11-26)