CAJ | 학술논문

目的比较不同类型药疹患者血清学及细胞中颗粒溶素表达差异.方法酶联免疫吸附试验(ELISA)和流式细胞仪分别检测7例中毒性表皮坏死松解症、5例Stevens-Johnson综合征进展期患者、8例多形红斑药疹患者、8例发疹型药疹患者及11例健康人血清及外周血T细胞中颗粒溶素的表达水平.利用SPSS17.0进行统计学分析,两组均数比较采用随机或配对t检验,3组间比较采用ANOVA分析.结果中毒性表皮坏死松解症和Stevens-Johnson综合征急性期患者血清颗粒溶素水平为(0.196±0.079) μg/L,明显高于发疹型药疹患者[(0.022±0.003) μg/L]和健康对照[(0.013±0.005) μg/L],F=3.926,P＜0.05,但与多形红斑患者[(0.058±0.004) μg/L]相比差异无统计学意义.Stevens-Johnson综合征患者和中毒性表皮坏死松解症患者表达颗粒溶素的CD8+T细胞比例为(3.400±0.754)％,多形红斑组为(0.600±0.250)％,发疹型药疹组和健康对照组分别为(0.342±0.251)％和(0.054±0.024)％,4组间差异有统计学意义,F=11.4,P＜0.01.结论颗粒溶素在中毒性表皮坏死松解症、Stevens-Johnson综合征患者中表达水平较高,可能对该病急性期的鉴别诊断及预后评价具有潜在的应用价值.
목적 비교불동류형약진환자혈청학급세포중과립용소표체차이.방법 매련면역흡부시험(ELISA)화류식세포의분별검측7례중독성표피배사송해증、5례Stevens-Johnson종합정진전기환자、8례다형홍반약진환자、8례발진형약진환자급11례건강인혈청급외주혈T세포중과립용소적표체수평.이용SPSS17.0진행통계학분석,량조균수비교채용수궤혹배대t검험,3조간비교채용ANOVA분석.결과 중독성표피배사송해증화Stevens-Johnson종합정급성기환자혈청과립용소수평위(0.196±0.079) μg/L,명현고우발진형약진환자[(0.022±0.003) μg/L]화건강대조[(0.013±0.005) μg/L],F=3.926,P＜0.05,단여다형홍반환자[(0.058±0.004) μg/L]상비차이무통계학의의.Stevens-Johnson종합정환자화중독성표피배사송해증환자표체과립용소적CD8+T세포비례위(3.400±0.754)％,다형홍반조위(0.600±0.250)％,발진형약진조화건강대조조분별위(0.342±0.251)％화(0.054±0.024)％,4조간차이유통계학의의,F=11.4,P＜0.01.결론 과립용소재중독성표피배사송해증、Stevens-Johnson종합정환자중표체수평교고,가능대해병급성기적감별진단급예후평개구유잠재적응용개치.
Objective To compare the cellular and serum expression levels of granulysin among patients with different types of drug eruption.Methods Blood samples were collected from 7 patients with toxic epidermal necrolysis (TEN),5 patients with acute Stevens-Johnson syndrome (SJS),8 patients with erythema multiforme,8 patients with exanthematic drug eruption,and 11 healthy controls.Flow cytometry and enzyme-linked immunosorbent assay (ELISA) were performed to quantify the protein expression of granulysin in peripheral blood T cells and sera from these subjects,respectively.Data were processed by the SPSS17.0 software,and differences in these parameters were analyzed by one-way analysis of variance and independent or paired sample t-test.Results The serum level of granulysin in patients with TEN or acute SJS was significantly higher than that in those with exanthematic drug eruption and healthy controls ((0.196 ± 0.079) μg/L vs.(0.022 ± 0.003) μg/L and (0.013 ±0.005) μg/L,F =3.926,P ＜ 0.05),but similar to that in those with erythema multiforme ((0.058 ± 0.004) μg/L,P ＞0.05).Significant differences were observed in the proportion of CD8+ T cells expressing granulysin in peripheral blood mononuclear cells (PBMCs) between patients with TEN or acute SJS,erythema multiforme,exanthematic drug eruption,and healthy controls ((3.400 ± 0.754)％ vs.(0.600 ± 0.250)％ vs.(0.342 ± 0.251)％ vs.(0.054 ±0.024)％,F =11.4,P ＜ 0.01).Conclusions Granulysin is highly expressed in patients with TEN and SJS,which may have potential value for their differential diagnosis and prognosis evaluation at acute phase.