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【はじめに】アナフィラキシーは救急疾患であるが,本邦での全年齢にわたる疫学調査報告は少ない。 【目的】過去10年間に当院救急外来を受診した全年齢層のアナフィラキシー症例の原因アレルゲンについて検討した。 【対象と方法】2005年4月~2015年3月の間にアナフィラキシー疑いで救急外来を受診した患者を対象に診療録を後方視的に検討した。 【結果】対象はのべ387例(男 211例,女 176例)であり,小児が218例(56.3%),成人(15歳以上)が169例(43.7%)であった。最終的な被疑アレルゲンは食物が297例(76.7%)と最も多く,次いで薬剤 41例(10.6%),ハチ 23例(5.9%)であり,原因不明も18例(4.7%)あった。食物の内訳は鶏卵 50例(16.8%),乳製品 39例(13.1%),小麦 33例(11.1%),薬剤ではNSAIDs 18例(43.9%),抗菌薬 12例(29.3%)の順に多かった。小児の多くは食物が原因であるのに対し,成人では薬剤,ハチの割合が高かった。 【考察】アナフィラキシーの予防には,全年齢にわたる厳密な疫学調査が必要である。また,アナフィラキシーに対応する救急体制を整えるとともに,原因検索を正しく行う必要がある。
Background;Although anaphylaxis is a medical emergency, only few epidemiological surveys in all age have been reported in Japan. Object;We clarified the cause of patients with anaphylaxis of all age who visited the emergency department in our hospital in the past 10 years. Methods;We surveyed the medical records of patients who visited the emergency department for anaphylaxis for April 2005 to March 2015. Results;Data of 387 patients with anaphylaxis(176 women and 211 men)were examined in this study. They were 218(56.3%)children and 169(43.7%)adults(15 years or older). The most popular cause of anaphylaxis was food(297 cases, 76.7%), followed by drug(41 cases, 10.6%)and bee(23 cases, 5.9%). Unknown causes were 18 cases(4.7%). Among food allergen, egg was the most frequent cause(50 cases, 16.8%), followed by milk(39 cases, 13.1%)and wheat(33 cases, 11.1%). In drugs, NSAIDs were most popular(18 cases, 43.9%), and antimicrobials were second(12 cases, 29.3%). While many of the children experienced anaphylaxis due to food, various substances such as drugs, and bees were found as causes of anaphylaxis in adults. Conclusion;It is necessary not only to prepare the emergency system for anaphylaxis, but also determine the allergenic substance correctly.