非卡马西平所致药疹与HLA-B* 1502基因型相关性研究

Study on the correlation of drug eruption caused by non-carbamazepine antiepileptics and genotype of HLA-B* 1502

目的评价非卡马西平抗癫痫药所致药疹与HLA-B*1502基因型的相关性。方法用PCR-SS0探针法测定26例非卡马西平抗癫痫药物药疹的患者及8例用卡马西平药疹的患者外周血白细胞HLA-B*1502基因型,分析2组HLA-B*1502基因阳性结果,并进行对照。结果 26例非卡马西平用药患者中用奥卡西平15例(HLA-B*1502基因阳性1例,阴性14例),拉莫三嗪3例(HLA-B*1502基因为阴性),左乙拉西坦3例(HLA-B*1502基因为阴性),苯妥英钠2例(HLA-B*1502基因为阴性),苯巴比妥2例(HLA-B*1502基因均为阴性),丙戊酸钠1例(HLA-B*1502基因均为阴性)。8例用卡马西平患者,HLA-B*1502基因阳性5例,阴性3例。发生药疹的抗癫痫药物全部换用其他药物,非卡马西平过敏组HLA-B*1502基因型阳性率明显低于卡马西平过敏组(P<0.05)。结论非卡马西平的抗癫痫药药疹与HLA-B*1502基因型无明显相关性。对于用非卡马西平抗癫痫药药疹患者,若有需要可换用卡马西平。

Objective To discuss the correlation of drug eruption caused by non -carbamazepine antiepileptics and genotype of HLA-B＊1502. Methods The genotype of HLA -B＊1502 of patients, including 26 cases of drug eruptions caused by non -carbamaz-epine antiepileptics and 8 cases caused by carbamazepine , were detected in peripheral blood by the PCR -SS0 probe.Results There were 26 patients in the group of non -carbamazepine administration .The expres-sion of HLA-B＊1502 gene was positive in 1 case and negative in 14 ca-ses in the group of oxcarbazepine administration;the expression was neg-ative in all the 3 cases in the group of lamotrigine administration , the ex-pression was negative in all the 3 cases in the group of levetiracetam ad-ministration , the expression was negative in both of the 2 cases in the group of phenytoinum administration , the expression was negative in both the 2 cases in the group of phenobarbital administration , and the expres-sion was negative in 1 cases in the group of valproate administration . There were 8 patients in the group of carbamazepine administration .The expression of HLA-B＊1502 gene was positive in 5 cases and negative in 3 cases.Patients with drug eruption caused by antiepileptic drugs all＆amp;nbsp;changed the administration .The result showed that the positive expression rate of HLA-B＊1502 gene was lower in the group of non-carbamazepine administration than that in the group of carbamazepine administration （ P〈0.05 ）.Con-clusion There was no correlation between the drug eruption caused by non -carbamazepine administration and the genotype of HLA-B＊1502.Carbamazepine can be switched , if necessary , in cases who have drug eruption caused by administration of non -carbamazepine antiepileptics .