CAJ | 학술논문

目的：探究人疱疹病毒（HHV-6、 HHV-7、 EBV、 CMV）及细小病毒（PVB19）在各类型药疹患者中的感染状况。方法：收集2010年9月到2013年3月入住我院的147例药疹患者及33例正常对照者的血清，采用酶联免疫吸附法检测血清中HHV-6、HHV-7、EBV、CMV及PVB19抗原，分析药物超敏反应综合征（DIHS）患者（21例）、重症药疹（51例）、非重症药疹（75例）及正常人（33例）病毒感染的差异。结果：DIHS组、重症药疹组、非重症药疹组及对照组病毒感染总阳性率分别为71.4％、45.1％、21.3％、24.2％，其中 HHV-6阳性率分别为33.3％、21.6％、5.3％、0；HHV-7阳性率分别为33.3％、17.6％、8.3％、6.1％；EBV阳性率分别为42.9％、27.5％、12.0％、3.0％；CMV 阳性率分别为42.9％、23.5％、12.0％、9.1％；PVB19阳性率为9.5％、5.9％、4.0％、6.1％。 DIHS组病毒感染总阳性率明显高于重症药疹组和非重症药疹组与正常对照组（P值均＜0.05），重症药疹组和非重症药疹组与正常对照组比较病毒感染率无显著区别（P值均＞0.05）。 DIHS组与重症药疹组的4种人疱疹病毒感染阳性率均明显高于非重症药疹组及对照组（ P值均＜0.05），但4组间PVB19感染阳性率无统计学差异（ P值均＞0.05）。此外，DIHS组及重症药疹组多重感染率分别为38.1％、27.5％，明显高于非重症药疹组（9.3％）及对照组（6.1％）（P值均＜0.05）。结论：DIHS及重症药疹的发病与 HHV-6、HHV-7、EBV、CMV感染均有关，与PVB19感染无关，病毒感染可能参与药疹的发生并是病情加重的重要原因。
목적：탐구인포진병독（HHV-6、 HHV-7、 EBV、 CMV）급세소병독（PVB19）재각류형약진환자중적감염상황。방법：수집2010년9월도2013년3월입주아원적147례약진환자급33례정상대조자적혈청，채용매련면역흡부법검측혈청중HHV-6、HHV-7、EBV、CMV급PVB19항원，분석약물초민반응종합정（DIHS）환자（21례）、중증약진（51례）、비중증약진（75례）급정상인（33례）병독감염적차이。결과：DIHS조、중증약진조、비중증약진조급대조조병독감염총양성솔분별위71.4％、45.1％、21.3％、24.2％，기중 HHV-6양성솔분별위33.3％、21.6％、5.3％、0；HHV-7양성솔분별위33.3％、17.6％、8.3％、6.1％；EBV양성솔분별위42.9％、27.5％、12.0％、3.0％；CMV 양성솔분별위42.9％、23.5％、12.0％、9.1％；PVB19양성솔위9.5％、5.9％、4.0％、6.1％。 DIHS조병독감염총양성솔명현고우중증약진조화비중증약진조여정상대조조（P치균＜0.05），중증약진조화비중증약진조여정상대조조비교병독감염솔무현저구별（P치균＞0.05）。 DIHS조여중증약진조적4충인포진병독감염양성솔균명현고우비중증약진조급대조조（ P치균＜0.05），단4조간PVB19감염양성솔무통계학차이（ P치균＞0.05）。차외，DIHS조급중증약진조다중감염솔분별위38.1％、27.5％，명현고우비중증약진조（9.3％）급대조조（6.1％）（P치균＜0.05）。결론：DIHS급중증약진적발병여 HHV-6、HHV-7、EBV、CMV감염균유관，여PVB19감염무관，병독감염가능삼여약진적발생병시병정가중적중요원인。
Objective:To explore the role of human herpes virus ( HHV-6, HHV-7, EBV, CMV) and parvovirus ( PVB19 ) infection in the Etiology of drug eruption.Methods:The sera from patients with dermatitis medicamentosa ( n=147 ) and health volunteers ( n=33 ) were col-lected.Antigen of HHV-6, HHV-7, EBV, CMV and PVB19 were detected by ELISA.The differ-ences between patients with DIHS , severe drug eruption , non-severe drug eruption and healthy people were analyzed.Results:The virus infection rate of DIHS group, severe drug eruption group, non-severe drug eruption group and healthy controls was 71.4%, 45.1%, 21.3%, 24.2%, respectively, of which HHV-6-positive rates were 33.3%, 21.6%, 5.3%, 0;HHV-7-positive rates were 33.3%, 17.6%, 8.3%, 6.1%; EBV-positive rates were 42.9%, 27.5%, 12.0%, 3.0%;CMV-positive rates were 42.9%, 23.5%, 12.0%and 9.1%;PVB19 positive rate of 9.5%, 5.9%, 4.0%, 6.1%.Virus infection rate of DIHS group was obviously higher than other groups ( P<0.05 ) .There was no significant difference between severe drug eruption group, non-severe drug eruption group and healthy subjects ( P>0.05 ) .The seroprevalence of HHV ( HHV-6, HHV-7, EBV, CMV) in DIHS group and severe drug eruption group was signifi-cantly higher than non-severe drug eruption group and the control group ( P<0.05 ) .But there was no statistical difference in the seroprevalence of PVB19 among the four groups ( P>0.05 ) .In addition, multiple infection rates of DIHS group and severe drug eruption group were 38.1%, 27.5%, respectively, which significantly higher than the severe drug eruption group (9.3%) and control group (6.1%) .Conclusion:The onset of DIHS and severe drug eruption were correlated with the infection of HHV-6、HHV-7、EBV、CMV, but not PVB19.Therefore, HHV infection could be a trigger for the drug eruption getting worse.