青霉素类抗生素的交叉过敏反应研究  

The cross reaction of penicillin drugs

作　　者：乔海灵[1] 杨静[1] 

机构地区：[1]郑州大学临床药理研究所,河南郑州450052

出　　处：《中国医院药学杂志》2008年第10期826-829,共4页Chinese Journal of Hospital Pharmacy

基　　金：河南省杰出青年基金(编号:0312002100);河南省自然科学基金(编号:0211040100);河南省医学创新人才工程项目(编号;2002114)

摘　　要：目的:探讨青霉素类抗生素交叉过敏反应的机制。方法:采用放射免疫吸附试验(radioallergosorbent test,RAST)检测142例青霉素类过敏患者和101例健康受试者血清中针对4种青霉素类药物即青霉素G(PG)、青霉素V(PV)、氨苄西林(AP)、阿莫西林(AX)的8种抗原决定簇特异性IgE抗体(BPO、BPA、APO、APA、AXO、AXA、PVO、PVA-IgE)。结果:142例抗体阳性患者中,仅对一种抗原决定簇抗体阳性的占43,66%(62例),总的交叉过敏反应率为56,34%(80例)。BPO、BPA、APO、APA、AXO、AXA、PVO、PVA分别与其他7种抗原决定簇的交叉过敏反应率为29.58%,28,17%,30.28%,16.90%,16.90%,11.27%,14.08%,28.17%。仅对一种药物抗体阳性的占46.48%(66例),总的交叉过敏反应率为53.52%(76例),PG、AP、AX、PV分别与其他3种药物的交叉过敏反应率分剐为45.07%,40.85%,25.35%,36.62%。结论:特异性过敏反应在青霉素过敏反应中占有重要地位。青霉素类药物之间仅存在部分交叉过敏反应。OBJECTIVE To explore the mechanism of crossreaction of penicillin drugs. METHODS Radioallergosorbent test （RAST） was used to examine 8 kinds of specific IgE antibodies（BPO, BPA, APO, APA, AXO, AXA,PVO, PVA-IgE）, which included 4 kinds of penicillin drugs （PG, PV, AP and AX） in the sera of 142 penicillin allergic patients with positive IgE and 101 healthy subjects. RESULTS There were 43.66% （62） patients with only one kind of positive IgE, and there were 46. 48% （66） cases whose sera were positive only to one drug in positive IgE subjects. The crossreaction rates of BPO, BPA, APO, APA, AXO, AXA, PVO and PVA with others were 29.58%, 28. 17%, 30.28%, 16.90%, 16.90%, 11.27%, 14. 08% and 28. 17%, respectively. The cross positive rates of BP, AP, AX and PV with others were 45.07%, 40. 85%, 25.35% and 36. 62%, respectively. CONCLUSION The results show that partial cross reaction exists in penicillin allergy, and the specific reaction plays an important role in the allergic reactions.

关 键 词：过敏反应 青霉素 交叉反应 IGE抗体 入射免疫吸附试验 

分 类 号：R979.1[医药卫生—药品]