聚合酶链反应检测多形红斑皮损中单纯疱疹病毒DNA

DetectionofHerpesSimplexVirusDNAinCutaneousLesionsofErythemaMultiformebyPolymeraseChainReaction

为了研究多形红斑（ＥＭ）与单纯疱疹病毒（ＨＳＶ）之间的关系，特别是探讨与疱疹相关的ＥＭ的临床特点及其在ＥＭ发病中所占比例，应用聚合酶链反应（ＰＣＲ）方法检测了６０例ＥＭ的典型皮损的活检组织和３２例正常组织及疾病对照标本中的ＨＳＶＤＮＡ。结果显示：２１例（３５％）ＥＭ患者检测出ＨＳＶ特异ＤＮＡ，对照标本（１６份正常皮肤组织和１６份其它皮肤病的皮损标本）中未发现ＨＳＶＤＮＡ。根据病史提供，６０例ＥＭ中有５例是药物相关的ＥＭ，８例是病毒相关的ＥＭ，其余４７例为特发型ＥＭ。研究表明：２１例ＰＣＲＨＳＶＤＮＡ阳性的ＥＭ患者中，仅有２例发病前有口唇疱疹病史，１５／２１例（７１．４％）是复发性ＥＭ，发病高峰在冬季。尽管临床上无明显ＨＳＶ感染史，多数特发性ＥＭ也与疱疹病毒感染有关。ＰＣＲ技术是检测ＥＭ皮损中ＨＳＶ的快速、有效的方法，它可以决定病因上和ＨＳＶ感染有关的病例。

Inordertostudytherelationshipbetweenerythemamultiforme(EM)andherpessim-plexvirus(HSV),particularlytheclinicalfeaturesandtheproportionoftheherpes-asociatedEMinEM,skinbiopsyspecimensoftypicallesionsfrom60patientswithEMwereexaminedforthepresenceofHSVDNAbypolymerasechainreaction(PCR).HSVDNAwasalsoexaminedbyPCRin32controlsincludingbiopsyspecimenstakenfrom16normalskinand16otherskindiseases.Theresultsdemon-stratedthatHSV-specificDNAwaspositivein21(35%)patientswithEM,whilealcontrolswerenegative.Accordingtothehistoryofthepatients,among60casesofEM,5weredrug-associatedEM,8werevirus-associatedEM,theremains47wereidiopathic.Thestudyshowedthatin21HSVDNApositivecases,only2hadherpeslabialisprecedingtheonsetofEM;15/21(71.4%)casespresentedrecurentEM;theonsetwasmostlyinthewinter.TheidiopathicEMinthisgrouphadanassociationwithherpesvirusinfectioninmostcasesdespitetheabsenceofclinicalyapparentHSVinfection.PCRcanprovideaquickandefectivemethodfordetectingHSVinEMlesionsanddeterminetheHSV-aso-ciatedcases.