Current knowledge of Kounis syndrome induced by non-steroidal anti-inflammatory drugs (NSAIDs) is based on case reports. This study aimed to investigate the clinical features of Kounis syndrome.

Case reports of the NSAIDs-induced Kounis syndrome were analyzed by searching Chinese and English databases from 1 January 1950 to 31 January 2022.

The median age of the 45 included patients (28 women) was 51 years (20–80 years). NSAIDs that were the most frequently involved were diclofenac (26.7%, 12/45), metamizole (15.6%, 7/45), and aspirin (13.3%, 6/45). Kounis syndrome occurred mainly within 30 min after administration, with a maximum latency of 1 month. Chest pain (75.6%, 34/45), dyspnea (33.3%, 15/45), and allergic reactions (44.4%, 20/45) were the most common clinical manifestations. Thirty patients (66.7%) had an ST-segment elevation on the electrocardiogram. Echocardiogram and coronary angiography showed abnormalities in 21 patients (75%, 21/28) and 15 patients (37.5%, 15/40). Forty-four patients (97.8%) had a good prognosis after treatment with steroids, antihistamines, and vasodilators.

The possibility of Kounis syndrome should be considered in the presence of coronary artery disease symptoms when taking NSAIDs. Kounis syndrome can be life-threatening. It is essential to identify and treat Kounis syndrome correctly.

目前对非甾体抗炎药 (NSAID) 引起的 Kounis 综合征的了解基于病例报告。本研究旨在探讨 Kounis 综合征的临床特征。

检索1950年1月1日至2022年1月31日中英文数据库，分析非甾体抗炎药引起的Kounis综合征病例报告。

45 名患者（28 名女性）的中位年龄为 51 岁（20-80 岁）。最常见的非甾体抗炎药是双氯芬酸（26.7%，12/45）、安乃近（15.6%，7/45）和阿司匹林（13.3%，6/45）。Kounis综合征主要发生在给药后30 min内，最长潜伏期为1个月。胸痛（75.6%，34/45）、呼吸困难（33.3%，15/45）和过敏反应（44.4%，20/45）是最常见的临床表现。30 名患者 (66.7%) 的心电图 ST 段抬高。超声心动图和冠状动脉造影显示异常 21 例（75%，21/28）和 15 例（37.5%，15/40）。44 名患者（97.8%）在接受类固醇、抗组胺药和血管扩张剂治疗后预后良好。

服用非甾体抗炎药时，如果出现冠状动脉疾病症状，应考虑 Kounis 综合征的可能性。Kounis 综合征可能会危及生命。正确识别和治疗 Kounis 综合征至关重要。