药物性小肠结肠炎综合征文献病例分析

    Literature Case Analysis of Drug-induced Enterocolitis Syndrome

    • 摘要:
      目的 研究药物性小肠结肠炎综合征(drug-induced enterocolitis syndrome,DIES)的发生规律和特点,为临床安全用药提供参考。
      方法 检索各数据库建库至2024年12月收录在PubMed、Embase、中国知网、万方和维普期刊数据库的DIES病例报道,提取并整理分析患者信息、药物信息、临床表现、治疗过程等资料。
      结果 共纳入11篇文献,合计13例患者,均为欧美人群,男女比例为7∶6,其中未成年人占比76.92%(10/13)。涉及的药物包括阿莫西林(5例)、阿莫西林克拉维酸(5例)、对乙酰氨基酚(2例)及泮托拉唑(1例)。药物激发试验后,发生DIES的潜伏期为1~4 h。DIES主要临床表现为持续性呕吐、恶心、腹痛、腹泻、嗜睡等,并可能引起脱水、血压下降、心率加快、血氧饱和度下降。患者预后较好,经及时补液、昂丹司琼、皮质类固醇、抗组胺药等治疗后,数小时至数天内症状可缓解。
      结论 DIES是一种罕见的药物导致的迟发性过敏反应,了解其特点与临床表现,对出现急性胃肠道症状患者的评估具有重要意义。临床在使用相关药物过程中,应警惕该反应的发生,必要时及时停药或调整治疗方案,以确保用药安全。

       

      Abstract:
      OBJECTIVE To investigate the occurrence pattern and characteristics of drug-induced enterocolitis syndrome(DIES), and to provide reference for safe clinical medication.
      METHODS Case reports of DIES published in PubMed, Embase, CNKI, Wanfang, and VIP journal databases from their inception to December 2024 were retrieved. Patient demographics, drug information, clinical manifestations, and treatment processes were extracted and analyzed.
      RESULTS A total of 11 articles involving 13 patients were included. All patients were from European and American populations, with a male to female ratio of 7∶6. Among them, minors account for 76.92%(10/13). The implicated drugs were amoxicillin(5 cases), amoxicillin/clavulanic acid(5 cases), acetaminophen(2 cases), and pantoprazole(1 case). The latency period for DIES after drug provocation test ranged from 1 to 4 hours. The clinical symptoms of DIES mainly included persistent vomiting, nausea, abdominal pain, diarrhea, and drowsiness, which might cause dehydration, decreased blood pressure, increased heart rate, and decreased blood oxygen saturation. The patient had a good prognosis, and timely treatment with fluid replacement, ondansetron, corticosteroids, and antihistamines, symptoms resolved within hours to days.
      CONCLUSION DIES is a rare delayed allergic reaction caused by medication. Understanding its characteristics and clinical manifestations is crucial for evaluating patients with acute gastrointestinal symptoms. Clinicians should be alert to the occurrence of this reaction during the use of related drugs. Timely drug discontinuation or treatment adjustment should be considered when necessary to ensure medication safety.

       

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