摘要
目的:观察人类疱疹病毒-6(HHV-6)感染在药疹发病中的作用。方法:收集127例住院的药疹患者和67名正常对照者。用实时荧光定量PCR测定药疹患者和67名正常对照者的血清HHV-6DNA载量,并用ELISA测定患者和正常对照者的血清HHV-6IgM和HHV-6IgG。结果:127例药疹患者中15例(11.8%)患者有HHV-6活动性感染,其中以药物超敏综合征(DIHS)最多见,占46.7%,还可见于发疹型(EE)、多形红斑型(EM)、Stevens-Johnson综合征(SJS)和剥脱性皮炎型(ED)。HHV-6感染组男性的药疹发生率高于无HHV-6感染组(P<0.05);HHV-6感染组DIHS的发生率显著高于无HHV-6感染组(P<0.01);HHV-6感染组较无HHV-6感染组更易发生发热(P<0.05)、淋巴结肿大、肝功能损害、肾功能损害、嗜酸粒细胞增多(P均<0.01);HHV-6感染患者药疹发病潜伏期和病情控制时间均显著长于无HHV-6感染组(P<0.01);药疹患者入院时和恢复期的HHV-6IgG阳性率均显著高于正常对照组(P<0.01)。结论:HHV-6感染在药疹发病中起一定作用;HHV-6活动性感染最常见于DIHS,也可见于EE、EM、SJS和ED;HHV-6感染与DIHS的发生密切相关;有HHV-6活动性感染的患者病情重、系统损害多、潜伏期长、治疗所需时间长;药疹患者有较高的HHV-6潜伏感染率。
Objective To investigate the role of human herpesvirus-6 (HHV-6) in cutaneous drug eruptions. Methods One hundred and twenty-seven patients with cutaneous drug eruptions and 67 healthy controls were enrolled in the study. Real-time polymerase chain reaction (PCR) was performed for the assessment of HHV-6 DNA in serum of the patients and the healthy controls. HHV-6 IgG and IgM antibody levels were measured by ELISA. Results Fifteen patients (11.8%)had active HHV-6 infection, of whom drug-induced hypersensitivity syndrome (DIHS) was the most frequent (46.7%). Besides, HHV-6 infection had also been demonstrated in exanthematous eruptions (EE), erythema muhiforme (EM), Stevens- Johnson syndrome (SJS) and exfoliative dermatitis (ED). The males were more likely to have active HHV-6 infection (P〈0.05). The incidence of DIHS was higher in the patients with HHV-6 infection than those without HHV-6 infection (P〈0.01). The patients who had HHV-6 infection were more susceptible to fever (P〈0.05), lymphadenopathy, liver and renal function insufficiency and eosinophilia (P〈0.01). The latency or course for diseasecontrolling of patients with HHV-6 infection was significantly longer than that of those without HHV-6 infection (P〈0.01). The positive rate of HHV-6 IgG was higher in patients with cutaneous drug eruptions than that in healthy controls (P〈 0.01). Conclusions HHV-6 infection played a role in cutaneous drug eruptions. HHV-6 infection is most frequent in DIHS, and then in EE, EM, SJS and ED. The development of DIHS is correlated with HHV-6 infection. HHV-6 infection might contribute to the severity, latency, prolonged course, and occurrence of complication of cutaneous drug eruptions. Cutaneous drug eruptions are prone to occur in patients with latent HHV-6 infection.
出处
《诊断学理论与实践》
2009年第3期317-321,共5页
Journal of Diagnostics Concepts & Practice
关键词
药疹
人类疱疹病毒-6
药物超敏综合征
Cutaneous drug eruptions
Human herpesvirus-6
Drug-induced hypersensitivity syndrome