非甾体抗炎药诱发急性荨麻疹和血管性水肿18例临床分析及炎性因子检测

胡枫; 陈柳青

doi:10.13201/j.issn.1009-5918.2020.05.005

非甾体抗炎药诱发急性荨麻疹和血管性水肿18例临床分析及炎性因子检测

胡枫,
陈柳青^,

- 武汉市第一医院皮肤科(武汉, 430022)
基金项目:
国家自然科学基金项目(No:81974474)

详细信息

通讯作者: 陈柳青,E-mail:chlq35@126.com

中图分类号: R758.24

收稿日期: 2020-04-17

Clinical analysis and detection of inflammatory factors of 18 cases of acute urticaria and angioedema induced by non-steroidal anti-inflammatory drugs

HU Feng,
CHEN Liuqing^,

- Department of Dermatology, Wuhan No. 1 Hospital, Wuhan, 430022, China

More Information

Corresponding author: CHEN Liuqing, E-mail: chlq35@126.com

Received Date: 17 April 2020

摘要

摘要: 目的:研究分析非甾体抗炎药诱发急性荨麻疹和血管性水肿的临床特点和炎性因子表达,为此类疾病的防治提供一定科学依据。方法:收集我院皮肤科2018-03—2019-07期间收治的18例由非甾体类抗炎药诱发的急性荨麻疹和或血管性水肿患者的基本信息、临床资料和相关炎性因子,包括年龄、性别、皮疹表现、诱因、治疗及血清总IgE、CRP、IL-6、TNF-α水平,皮疹发作期和消退期的血清细胞因子水平分别作为诱导组和消退组,另选取在我院进行健康体检者的血清20例作为对照组,分别用电化学发光法、免疫比浊法及化学发光法检测总IgE、CRP及IL-6、TNF-α的表达水平。结果:18例患者中,男7例(38.9%),女11例(61.1%);平均年龄39(33.5~49.5)岁;皮疹表现荨麻疹合并血管性水肿13例(72.2%),单发荨麻疹2例,单发血管性水肿3例;药物诱因中双氯芬酸钠为7例(33.3%),布洛芬5例(27.8%),吲哚美辛、阿司匹林和美洛昔康各2例;18例患者仅有2例患者血清总IgE水平高于正常(11.1%),此2例患者使用了西替利嗪治疗,其余患者均联合使用了泼尼松;诱导组血清CRP和IL-6水平均明显高于对照组和消退组(P<0.05),各组TNF-α水平均在正常范围,差异无统计学意义。结论:NSAIDs诱发急性荨麻疹和血管性水肿患者以青中年人群为主,临床表现多为荨麻疹合并血管性水肿,诱因中双氯芬酸钠和布洛芬较常见,血清总IgE多数不高,皮疹发作期炎症因子CRP和IL-6表达上升,提示有全身的活动性炎症,治疗需抗组胺药物联合系统使用糖皮质激素。
- 非甾体抗炎药 /
- 荨麻疹 /
- 血管性水肿 /
- 炎性因子
Abstract: Objective: To study and analyze the clinical characteristics and inflammatory factors expression of acute urticaria and angioedema induced by NSAIDs, to provide some scientific basis for the prevention and treatment of such diseases. Method: The basic information, clinical datas and related inflammatory factors of 18 patients with acute urticaria and angioedema induced by NSAIDs were collected from March 2018 to July 2019 in the department of dermatology in our hospital, including age, sex, rash manifestation, inducement, treatment, serum total IgE, CRP, IL-6, TNF-α levels. The serum cytokine levels in rash onset and regression phases were used as the induction group and the regression group, respectively, and 20 serum samples of healthy people who were examined in our hospital were selected as the control group. The expression levels of total IgE, CRP and IL-6, TNF-α in different groups were detected by electrochemiluminescence, immunoturbidimetry and chemiluminescence, respectively. Result: The average age of 18 patients was 39(33.5-49.5), 7(38.9%) males and 11(61.1%) females. 13 cases(72.2%) manifested as urticaria with angioedema, 2 single urticaria and 3 single angioedema. Among the induced drugs, 7(33.3%) were diclofenac sodium, 5(27.8%) ibuprofen, 2 indomethacin, 2 aspirin and 2 meloxicam, respectively. In 18 patients, only 2 patients had higher serum total IgE level than normal(11.1%), the two patients were treated with cetirizine, and the rest patients were combined with prednisone. The serum CRP and IL-6 levels in the induction group were significantly higher than those in the control group and the regression group(P<0.05), and the TNF-α levels in each group were in the normal range, there was no difference in expression.Conclusion: The patients with acute urticaria and angioedema induced by NSAIDs are mainly young and middle-aged people. The clinical manifestations are mainly urticaria with angioedema. Diclofenac sodium and ibuprofen are common inducements, the total IgE in serum is generally not high, and the levels of CRP and IL-6 in the rash stage are increased, suggesting that there is systemic active inflammation. The treatment requires the use of glucocorticoid combined with antihistamines hormone.
- non-steroidal anti-inflammatory drugs /
- urticaria /
- angioedema /
- inflammatory factors

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