关键词: 荨麻疹, 感染, 糖皮质激素类, 阿奇霉素

Abstract: Kang Yuying, He Xiao, Liu Yong, Chang Huiling, Deng Qi, Yang Yuanwen, Xu Kai, Guo Rong, Wang Li Department of Dermatology and Venereology, Shanxi Dayi Hospital, Taiyuan 030032, China Corresponding authors: Kang Yuying, Email: kyuying2349@163.com; Wang Li, Email: tywangli@yeah.net 【Abstract】 Objective To analyze the precipitating factors for, clinical manifestations of, laboratory findings in and therapeutic effect on acute urticaria. Methods Clinical data were collected from 185 inpatients with acute urticaria in Shanxi Dayi Hospital from January 2013 to December 2016. Clinical features, laboratory examination results, treatment, prognosis and adverse reactions were analyzed retrospectively. Statistical analysis was carried out by chi-square test. Results There were 63 male patients and 122 female patients in this study, with an average age at onset of 32.87 ± 14.18 years. Of the 185 patients, 78 （42.2%） were able to report the aetiological agents accurately, 33 （17.8%） were induced by infection or drug therapy following infection, and 82 （44.3%） had fever. Blood cell analysis showed increased white blood cell count in 132 （71.4%） cases and increased proportion of neutrophils in 128 （69.2%） cases. The level of C reactive protein increased in 118 （69%） of 171 cases. A total of 185 patients received routine anti-anaphylactic treatment. Of 183 cured patients, 153 （83.6%） were treated with antibiotics, 26（14.2%）with antibiotics alone, and 24（13.1%） with azithromycin. There were 127 （69.4%） patients receiving combined treatment with glucocorticoids, antibiotics, and so on, and the antibiotic used in 111 （60.7%） cases was azithromycin. Of 88 cured patients with simultaneous signs of infection, 85 （96.6%） showed increased levels of part or all of infection markers （including the white blood cell count, proportion of neutrophils and level of C reactive protein）, and 69 （78.4%） were treated with azithromycin. Of 95 cured patients without signs of infection, 83 （87.4%） showed increased levels of infection markers, and 61 （64.2%） were treated with azithromycin. Moreover, there were significant differences in the proportion of patients with increased levels of infection markers and that of patients treated with azithromycin between the cured patients with and without signs of infection （χ2 = 5.164, 4.476, both P < 0.05）. Conclusions Infection is a common cause of acute urticaria, and laboratory examinations including white blood cell count, proportion of neutrophils and level of C reactive protein are of important reference value to the diagnosis of infection in patients with acute urticaria. Patients with signs of infection or increased levels of infection markers need to be treated with combined anti-infective therapy, and in the cured patients, the proportion of patients administrating azithromycin was higher than that of those administrating other antibiotics for the treatment of acute infectious urticaria.

Key words: Urticaria, Infection, Glucocorticoids, Azithromycin