微柱凝胶法检测血液中两种抗菌药物诱导形成药物性抗体的研究

Study on detection of drug antibodies induced by two antibiotics in plasma by micro-column gel testing method

目的探讨微柱凝胶法检测头孢哌酮钠舒巴坦钠和哌拉西林钠舒巴坦钠诱导患者体内形成药物性抗体的可能性。方法应用微柱凝胶法对112例头孢哌酮钠舒巴坦钠和76例哌拉西林钠舒巴坦钠使用者的血液标本进行抗人球蛋白试验和相应药物性抗体的检测。结果使用药物之前所有患者标本中不规则抗体、直接抗人球蛋白试验、药物性抗体检测结果均为阴性。112例头孢哌酮钠舒巴坦钠患者血浆中药物性抗体阳性有35例(31.25%),76例哌拉西林钠舒巴坦钠患者血浆中药物性抗体阳性有14例(18.42%),差异有统计学意义(P<0.05)。直接抗人球蛋白试验阳性的标本中,两种药物性抗体的阳性率分别为47.82%和46.15%,但差异无统计学意义(P>0.05);直接抗人球蛋白试验阴性的标本中,头孢哌酮钠舒巴坦钠药物性抗体的阳性率(26.97%)明显高于哌拉西林钠舒巴坦钠药物性抗体的阳性率(12.70%),差异有统计学意义(P<0.05)。结论临床使用头孢哌酮钠舒巴坦钠和哌拉西林钠舒巴坦钠对患者进行治疗,无论直接抗人球蛋白试验结果是否为阳性,都可能产生相应的药物性抗体;而头孢哌酮钠舒巴坦钠抗体形成的可能性高于哌拉西林钠舒巴坦钠。

Objective To investigate the possibility of drug antibody formation in patients using cefoperazone sodium sulbactam sodium and piperacillin sodium sulbactam sodium by micro-column gel testing method.Methods The blood samples of 112 cefoperazone sodium and sulbactam sodium and 76 piperacillin sodium and sulbactam sodium users were analyzed by micro-column gel testing method to test the drug antibodies induced by two antibiotics.Results All tested results of irregular antibody,direct anti-human globulin test,and drug antibody tests were negative before the usage of drug.Among the 112 patients used cefoperazone sodium sulbactam sodium,35 cases(31.25%)had positive drug antibody in plasma.And in 76 patients used piperacillin sodium sulbactam sodium,14 cases(18.42%)had positive drug antibody in plasma,differences were statistically significant(P<0.05).In the positive samples of direct anti-human globulin test,the positive rates of the antibody production of two drugs were 47.82%and 46.15%,respectively,but differences were not statistically significant(P>0.05).In the negative samples of direct anti-human globulin test,the positive rate of cefoperazone sodium sulbactam sodium drug antibody(26.97%)was significantly higher than that of piperacillin sodium and sulbactam sodium drug antibody(12.70%),and the difference was statistically significant(P<0.05).Conclusion When cefoperazone sodium sulbactam sodium and piperacillin sodium sulbactam sodium has been used in clinic,no matter the results of direct anti-human globulin test is positive or not,drug antibodies may produce.While,the possibility of cefoperazone sodium sulbactam sodium antibody formation is higher than that of piperacillin sodium sulbactam sodium.