CAJ | 학술논문

目的探讨人巨细胞病毒(CMV)感染在药疹发病中的作用.方法收集44例药疹患者(其中重型药疹13例)及50例健康对照外周血,Taqman实时荧光定量PCR (RT-PCR)检测外周血单一核细胞中CMV DNA阳性率及载量;酶联免疫吸附试验(ELISA)检测血清CMV IgM阳性率.结果 44例药疹患者CMV DNA阳性率(65.91％,29/44例)高于健康对照组(28.00％,14/50例),差异有统计学意义(x2=13.552,P＜0.05);重型药疹患者(11/13例)、轻型药疹患者(58.06％,18/31例)及健康对照组CMV DNA阳性率不完全相等(x2=16.153,P＜ 0.05),其中重型组高于轻型组(x2=13.817,P＜0.05)及对照组(x2=7.237,P＜0.05);药疹患者CMV DNA载量(28 183.829±19 527.654)拷贝高于健康对照组(3 019.952±1 760.952)拷贝,差异有统计学意义(t'=8.517,P＜ 0.05),重型药疹患者(554 813.389±722 642.498)拷贝、轻型药疹患者(13 290.558±14 082.356)拷贝与对照组间CMV DNA载量差异无统计学意义(P＞0.05).药疹患者CMV IgM阳性率(13.64％,6/44例)与健康对照组(6.00％,3/50例)差异无统计学意义(P＞0.05);轻型药疹(6.45％,2/31例)、重型药疹(4/13例)及健康对照组各组均数不完全相等(x2=7.832,P＜0.05),其中重型组高于对照组(x2=6.409,P＜ 0.05).结论药疹患者存在CMV感染,CMV感染可能是药疹发病或加重的因素之一.
목적 탐토인거세포병독(CMV)감염재약진발병중적작용.방법 수집44례약진환자(기중중형약진13례)급50례건강대조외주혈,Taqman실시형광정량PCR (RT-PCR)검측외주혈단일핵세포중CMV DNA양성솔급재량;매련면역흡부시험(ELISA)검측혈청CMV IgM양성솔.결과 44례약진환자CMV DNA양성솔(65.91％,29/44례)고우건강대조조(28.00％,14/50례),차이유통계학의의(x2=13.552,P＜0.05);중형약진환자(11/13례)、경형약진환자(58.06％,18/31례)급건강대조조CMV DNA양성솔불완전상등(x2=16.153,P＜ 0.05),기중중형조고우경형조(x2=13.817,P＜0.05)급대조조(x2=7.237,P＜0.05);약진환자CMV DNA재량(28 183.829±19 527.654)고패고우건강대조조(3 019.952±1 760.952)고패,차이유통계학의의(t'=8.517,P＜ 0.05),중형약진환자(554 813.389±722 642.498)고패、경형약진환자(13 290.558±14 082.356)고패여대조조간CMV DNA재량차이무통계학의의(P＞0.05).약진환자CMV IgM양성솔(13.64％,6/44례)여건강대조조(6.00％,3/50례)차이무통계학의의(P＞0.05);경형약진(6.45％,2/31례)、중형약진(4/13례)급건강대조조각조균수불완전상등(x2=7.832,P＜0.05),기중중형조고우대조조(x2=6.409,P＜ 0.05).결론 약진환자존재CMV감염,CMV감염가능시약진발병혹가중적인소지일.
Objective To investigate the role of human cytomegalovirus (CMV) in the occurrence of drug eruptions.Methods Peripheral blood samples were collected from 44 patients with drug eruptions (including 13 severe cases) and 50 healthy human controls.Taqman fluorescent real-time quantitative PCR (RT-PCR) was performed to determine the positive rate and load of CMV DNA in peripheral blood mononuclear cells (PBMCs).Enzyme-linked immunosorbent assay (ELISA) was conducted to detect anti-CMV IgM antibodies in sera.Results The positive rate of CMV DNA was significantly higher in the patients than in the controls (65.91％ (29/44) vs.28.00 ％ (14/50),x2 =13.552,P ＜ 0.05),significantly different among patients with severe drug eruptions (11/13),patients with mild drug eruptions (58.06％ (18/31)) and the controls (x2 =16.153,P ＜ 0.05).In addition,patients with severe drug eruptions showed a higher positive rate of CMV DNA compared with patients with mild drug eruptions (x2 =13.817,P ＜ 0.05) and the controls (x2 =7.237,P ＜ 0.05).CMV DNA load was significantly higher in the patients than in the controls ((28 183.829 ± 19 527.654) vs.(3 019.952 ± 1 760.952) copies,t' =8.517,P ＜ 0.05).No significant difference was found in CMV DNA load between patients with severe drug eruptions ((554 813.389 ± 722 642.498) copies),patients with mild drug eruptions ((13 290.558 ± 14 082.356) copies)) and the controls (P ＞ 0.05).The positive rate of anti-CMV IgM antibodies was similar between the patients and controls (13.64％ (6/44) vs.6.00％ (3/50),P ＞ 0.05),but significantly different among patients with severe drug eruptions (4/13),patients with mild drug eruptions (6.45％,2/31) and the controls (x2 =7.832,P ＜ 0.05),and significantly higher in patients with severe drug eruptions than in the controls (x2 =6.409,P ＜ 0.05).Conclusions CMV infection exists in patients with drug eruptions,and might be a factor associated with the initiation and aggravation of drug eruptions.