HIV感染伴湿疹皮炎患者免疫状态与致敏原斑贴试验结果

Investigation of the contact allergens of HIV-infected patients with eczema/dermatitis and relationship with immune functions

目的了解HIV感染伴湿疹皮炎患者的接触致敏情况,并初步分析其与免疫功能状态的关系。方法采用欧洲标准变应原系列对门诊或病房就诊的HIV感染伴湿疹皮炎患者进行斑贴试验及随访,采用病史回顾和随访的方法来确定斑贴试验结果的相关性。结果共入组HIV感染伴湿疹皮炎患者99例,其中男性97例,平均年龄为(34.6±8.9)岁。共有29例(29.3%)患者出现至少一种斑试物质斑贴试验阳性,斑试阳性物质阳性率由高到低分别为氯化钴(11.1%)、硫酸镍(10.1%)、卡巴混合物(8.1%)、对苯二胺(4.0%)、芳香混合物(3.0%)、甲醛(2.0%)、重铬酸钾(1.0%)、尼泊金混合物(1.0%)和倍半萜烯内酯混合物(1.0%)。患者中CD4细胞<200个/μL者和≥200个/μL者的斑贴试验阳性率分别为30.0%和29.1%,两组间阳性率差异无统计学意义(P>0.05)。CD8细胞>836个/μL者和≤836个/μL者的斑贴试验阳性率分别为39.2%和18.8%,两组间差异有统计学意义(P <0.05)。患者中CD4/CD8比值<1者和≥1组的斑贴试验阳性率分别为30.4%和14.3%,两组间阳性率差异无统计学意义(P>0.05)。结论对HIV感染伴湿疹皮炎患者进行斑贴试验,有利于查找这一人群中湿疹皮炎的原因以及预防复发;斑贴试验阳性率与患者CD8细胞计数有关,但接触致敏与免疫状态的关系仍待进一步研究。

Objective To understand the contact allergy status of HIV infected patients with eczema and dermatitis,and to analyze its relationship with immune function. Methods European standard allergen series were used to conduct patch tests and follow-up on HIV-infected patients with eczema dermatitis in outpatient departments and clinical wards.The correlation between patch test results was determined by history review and follow-up. Results A total of 99 patients with HIV infection and eczema dermatitis were enrolled, including 97 males, with an average age of(34.6±8.9)years. A total of 29 patients(29.3%) had at least one patch test positive. The positivity rates of patch test substances from high to low were cobalt chloride(11.1%), nickel sulfate(10.1%), carbamate mixture(8.1%), p-phenylenediamine(4.0%),aromatic mixture(3.0%), formaldehyde(2.0%), potassium dichromate(1.0%) and Nipagin mixture(1.0%), and sesquiterpene lactone mixture(1.0%). The positive rates of patch tests among people with CD4 cells < 200/μL and ≥ 200/μL were 30.0% and 29.1%, respectively. There was no significant difference between the two groups(P > 0.05). The positive rates of patch tests among people with CD8 cells >836/μ L and ≤ 836/μL were 39.2% and 18.8%, respectively.The differences between groups had statistical significance(P<0.05). The positive rates of patch tests in patients with CD4/CD8 < 1 and ≥ 1 were 30.4% and 14.3%, respectively(P>0.05). Conclusion The patch test for HIV-infected patients with eczema dermatitis is helpful to find out the causes of eczema dermatitis and prevent a recurrence. The positive rate of the patch test is related to the number of CD8 cells, but the relationship between contact allergic and immune status remains to be further studied.