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临床药师对1例瑞巴派特致Stevens-Johnson综合征的药学分析
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龚文俊 ，邹 剑 ，徐 翰 ，边 原 （1.彭州市人民医院临床药学科，四川 彭州 611930；2.西南医科大学附
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属自贡医院临床药学科，四川 自贡 643020；3.四川省医学科学院·四川省人民医院/电子科技大学附属医院药
学部个体化药物治疗四川省重点实验室，成都 610072）
中图分类号 R969.3 文献标志码 A 文章编号 1001-0408（2023）10-1262-04
DOI 10.6039/j.issn.1001-0408.2023.10.21
摘 要 目的 为瑞巴派特致 Stevens-Johnson 综合征的诊治提供参考，并探讨患者发生 Stevens-Johnson 综合征的易感因素。方
法 临床药师整理分析1例胃肠疾病患者的治疗过程，评价该患者所用药物与不良反应的关联性，以判断引起Stevens-Johnson综
合征的可疑致敏药物；同时探讨患者发生Stevens-Johnson综合征的易感因素。结果与结论 引起该患者发生Stevens-Johnson综合
征的可疑致敏药物包括艾普拉唑肠溶片、瑞巴派特片、康复新液。根据国家药品不良反应监测中心因果关系评价方法、诺氏评估
量表、表皮坏死松解症的药物因果关系算法（ALDEN）评分标准，综合判断引起Stevens-Johnson综合征的可疑致敏药物为瑞巴派
特。低蛋白状态、药物之间竞争性结合血浆蛋白、高龄、细菌合并病毒感染可能是该患者发生Stevens-Johnson综合征的易感因素。
因此临床在使用瑞巴派特前，应详细询问患者过敏史，在使用过程中应加强对患者的用药监护，警惕严重的不良反应的发生，如发
现异常应立即停药并及时给予对症处理，以保障患者用药的安全性和有效性。
关键词 瑞巴派特；Stevens-Johnson综合征；药品不良反应
Pharmaceutical analysis for a patient with rebamipide-induced Stevens-Johnson syndrome by clinical
pharmacists
GONG Wenjun ，ZOU Jian ，XU Han ，BIAN Yuan（1. Dept. of Clinical Pharmacy，Pengzhou Municipal People’s
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Hospital， Sichuan Pengzhou 611930，China；2. Dept. of Clinical Pharmacy，the Affiliated Zigong Hospital of
Southwest Medical University， Sichuan Zigong 643020，China；3. Personalized Drug Therapy Key Laboratory of
Sichuan Province， Dept. of Pharmacy of Sichuan Academy of Medical Sciences·Sichuan Provincial People’s
Hospital/Affiliated Hospital of University of Electronic Science and Technology， Chengdu 610072， China）
ABSTRACT OBJECTIVE To provide reference for the diagnosis and treatment of Stevens-Johnson syndrome caused by
rebamipide， and to explore the predisposing factors of Stevens-Johnson syndrome. METHODS Clinical pharmacists analyzed the
treatment process of a patient with gastrointestinal diseases and evaluated the correlation between the drug used and adverse
reactions， in order to determine the suspected allergenic drug causing Stevens-Johnson syndrome. The predisposing factors of
patients with Stevens-Johnson syndrome were explored. RESULTS & CONCLUSIONS The suspected allergenic drugs that caused
the patient to develop Stevens-Johnson syndrome included Ilaprazole enteric-coated tablets， Rebamipide tablets and Kangfuxin
liquid. In summary， the suspect drug was identified as Rebamipide tablets according to the causality evaluation method of the
National Center for Adverse Drug Reaction Monitoring， Naranjo’s scoring method and the algorithm of drug causality for
epidermal necrolysis scoring criteria. Hypoproteinemia， competitive binding of plasma proteins between drugs， advanced age，
bacterial and viral infections were the predisposing factors of Stevens-Johnson syndrome. Therefore， before using rebamipide in
clinical practice， it is necessary to inquire about the patient’s allergy history in detail. During the use process， it is necessary to
strengthen the patient’s medication monitoring and be alert to the occurrence of serious adverse reactions. If any abnormalities are
found， the medication should be stopped immediately and
Δ 基金项目 四川省干部保健科研课题（No.川干研2021-226）；成
都市医学科研课题（No.2020106） symptomatic treatment should be given as soon as possible to
＊第一作者 主管药师。研究方向：临床药学。电话：028-86235626。 ensure the safety and effectiveness of the patient’s medication.
E-mail：1692381883@qq.com
# 通信作者 副主任药师，硕士。研究方向：临床药学。电话：028- KEYWORDS rebamipide； Stevens-Johnson syndrome； adverse
87393405。E-mail：85778860@qq.com drug reaction
· 1262 · China Pharmacy 2023 Vol. 34 No. 10 中国药房 2023年第34卷第10期
