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目的探讨双硫仑样反应的发生机制、诊断和治疗。方法对32例双硫仑样反应病例的原因、临床表现和治疗过程进行回顾性分析。结果32例患者全部治愈,成功率为100%,无并发症发生。结论引起药源性双硫仑样反应的主要药物是含有甲硫四氢唑活性基的头孢类、硝咪唑类、呋喃类、氯霉素、灰黄霉素、磺脲类降糖药等。使用上述药物后10d内饮酒,可在5～60min内出现颜面及全身皮肤潮红、心慌、胸闷、濒死感等症状,通过积极对症处理,常在24h内恢复正常,若反应严重,处理不当,可致死亡,但如能早期诊断,及时抢救,多能很快治愈。医护人员应掌握并重视应用抗生素后引起的双硫仑样反应,告知患者使用此类药物时避免饮酒是重要的预防措施,积极预防此反应的发生。
Objective To investigate the mechanism, diagnosis and treatment of disulfiram-like reaction. Methods The causes, clinical manifestation and course of treatment of 32 cases of disulfiram-like reaction were retrospectively analyzed. Results 32 patients were all cured, the success rate was 100%, no complications. Conclusions The main drugs that cause drug-induced disulfiram-like reaction are cephalosporins, nitrofurans, furans, chloramphenicol, griseofulvin, and sulfonylureas that contain active methylthiotriazolium. After using the drug within 10d after drinking, can appear facial and systemic skin flushing within 5 ~ 60min, palpitation, chest tightness, morbidity and other symptoms, through positive symptomatic treatment, often returned to normal within 24h, if the reaction is serious, improper handling, Can cause death, but if early diagnosis, timely rescue, can quickly cure. Medical staff should grasp and pay attention to the application of antibiotics caused by disulfiram-like response, to inform patients to use such drugs to avoid alcohol is an important precautionary measures to actively prevent this reaction.