CAJ | 학술논문

目的：探讨 HIV 感染者服用复方磺胺甲唑（Co-SMZ）后诱发超敏反应的可能因素。方法采用回顾性研究的方法，收集2014年1月至11月就诊于江苏省南通市第三人民医院感染病科111例 HIV 感染者的年龄、性别、入院至确诊 HIV 感染的时间、既往药物超敏反应情况、服用 Co-SMZ当天外周静脉血 CD3＋ T 淋巴细胞、CD4＋ T 淋巴细胞、CD8＋ T 淋巴细胞、NK 细胞计数等资料，随访时间至服用 Co-SMZ 后2个月。正态分布或近似正态分布的计量资料采用 t 检验，偏态分布计量资料采用秩和检验，计数资料采用卡方检验。结果入组111例 HIV 感染者中，男107例，女4例，平均年龄（45．7±11．1）岁，预防性服用 Co-SMZ 的 HIV 感染者发生超敏反应时间为（14．0±7．6）d。CD4＋ T 淋巴细胞、NK 细胞表达水平在发生超敏反应组与未发生超敏反应组之间差异均有统计学意义（均 P ＜0．05）。多因素分析发现，NK 细胞与 Co-SMZ 诱发超敏反应相关（OR ＝1．010，95％CI ：1．005～1．017， P ＝0．001）。NK 细胞预测 Co-SMZ 诱发超敏反应的受试者工作特征（ROC）曲线下面积为0．748（95％CI ：0．647～0．850，Z ＝4．701，P ＝0．001），最佳预测值为109．80／μL，灵敏度为63．2％，特异度为84．7％。结论在 HIV 感染患者中，Co-SMZ 诱发的超敏反应可能与 NK 细胞计数有关。
목적：탐토 HIV 감염자복용복방광알갑서（Co-SMZ）후유발초민반응적가능인소。방법채용회고성연구적방법，수집2014년1월지11월취진우강소성남통시제삼인민의원감염병과111례 HIV 감염자적년령、성별、입원지학진 HIV 감염적시간、기왕약물초민반응정황、복용 Co-SMZ당천외주정맥혈 CD3＋ T 림파세포、CD4＋ T 림파세포、CD8＋ T 림파세포、NK 세포계수등자료，수방시간지복용 Co-SMZ 후2개월。정태분포혹근사정태분포적계량자료채용 t 검험，편태분포계량자료채용질화검험，계수자료채용잡방검험。결과입조111례 HIV 감염자중，남107례，녀4례，평균년령（45．7±11．1）세，예방성복용 Co-SMZ 적 HIV 감염자발생초민반응시간위（14．0±7．6）d。CD4＋ T 림파세포、NK 세포표체수평재발생초민반응조여미발생초민반응조지간차이균유통계학의의（균 P ＜0．05）。다인소분석발현，NK 세포여 Co-SMZ 유발초민반응상관（OR ＝1．010，95％CI ：1．005～1．017， P ＝0．001）。NK 세포예측 Co-SMZ 유발초민반응적수시자공작특정（ROC）곡선하면적위0．748（95％CI ：0．647～0．850，Z ＝4．701，P ＝0．001），최가예측치위109．80／μL，령민도위63．2％，특이도위84．7％。결론재 HIV 감염환자중，Co-SMZ 유발적초민반응가능여 NK 세포계수유관。
Objective To investigate the risk factors of hypersensitivity induced by compound sulfamethoxazole (Co-SMZ)in patients with human immunodeficiency virus (HIV)infection.Methods A retrospective study was performed in 111 patients with HIV infection receiving prophylactic Co-SMZ at the Department of Infectious Diseases,the Third People′s Hospital of Nantong City,Jiangsu Province from January 2014 to December 2014.Data including age,gender,interval time from diagnosis of HIV infection to hospitalization,history of drug allergy,and the counts of CD3 + T cell,CD4 + T cell,CD8 + T cell and natural killer (NK)cell on the day when the medicine was administrated for the first time were recorded. All the patients were followed up for two months.Student t test was used in data with normal distribution or approximate normal distribution.Rank sum test was used in data with skew distribution.The count materials were examined byχ2 test.Results Among the 111 patients with HIV infection,there were 107 males and 4 females with average age of (45 .7±11 .1)years old.The interval time from taking Co-SMZ to hypersensitivity was (14.0±7.6)d.There were differences in the counts of CD4 + T cell and NK cell between patients with hypersensitivity and without hypersensitivity (both P <0.05).Multivariate analysis showed that NK cell was a risk factor for inducing hypersensitivity (OR=1 .010,95 %CI :1 .005 -1 .017, P =0.001).The area under of receiver operating characteristic curve predicting hypersensitivity induced by Co-SMZ was 0.748 (95 %CI :0.647-0.850,Z =4.701 ,P =0.001).The best predictor was 109.80/μL with sensitivity of 63.2% and specificity of 84.7%.Conclusion In patients with HIV infection,NK cell might be associated with hypersensitivity induced by Co-SMZ.