目的 探讨质子泵抑制剂致过敏性休克的规律及特点,为其临床合理应用提供依据。方法 检索中国知网总库、万方数据总库、维普网、中国生物医学文献服务系统和PubMed、Web of Science数据库收录的1990—2022年间发表的质子泵抑制剂致过敏性休克相关案例报道文献,对符合要求的病例进行统计和分析。结果 共收集到82篇文献,共计84例质子泵抑制剂致过敏性休克。男女比例约为1∶1,以41~60岁和61~80岁患者居多,均占36.47%;具有食物或药物过敏史者占28.57%;共涉及5种药物,奥美拉唑、泮托拉唑、兰索拉唑分别位居前3位,占90.49%;以静脉方式给药的发生率最高,占60.71%;主要发生于首次用药,用药60 min内,占78.57%,其中最快为用药后几秒钟;主要临床表现为血压下降、大汗淋漓、心率加快、皮肤瘙痒、皮疹等;预后良好;不同的质子泵抑制剂间可能存在交叉过敏。结论 多种质子泵抑制剂均可引起过敏性休克,应引起广大医务工作者的关注,加强用药监护,保证患者用药安全。

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

吴阶平医学基金会临床科研专项(320.6750.2020-11-26)