不同类型重症药疹患者外周血淋巴细胞亚群分析及其临床意义  

Analysis and clinical significance of lymphocyte subsets in the peripheral blood in patients with different types of severe drug eruption

作　　者：孙杰[1] 张锦英[2] 丁高中[1] 龚晴丽 鲁严[1] 

机构地区：[1]南京医科大学第一附属医院皮肤科,江苏南京210029 [2]南京医科大学第一附属医院肿瘤科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2014年第6期777-781,共5页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金(81171517)

摘　　要：目的:检测不同类型重症药疹患者外周血淋巴细胞亚群并研究其临床意义。方法:采用免疫荧光标记流式细胞术检测21例重症药疹患者外周血淋巴细胞的表型。结果:药物超敏反应综合征(drug-induced hypersensitivity syndrome,DIHS)患者治疗前CD3+、CD3+CD4+淋巴细胞较正常值显著增加,并且DIHS患者治疗前CD3+CD4+淋巴细胞显著高于Stevens-Johnson综合征(Stevens-Johnson syndrome,SJS)和中毒性表皮坏死松解症(toxic epidermal necrolysis,TEN)患者;在SJS和TEN患者中,随着外周血CD3+CD4+、CD3+CD8+淋巴细胞数目的增加,激素最大控制用量逐渐减少,随着外周血CD3-CD16+CD56+淋巴细胞数目的增加,激素最大控制用量逐渐增加。结论:不同类型的重症药疹外周血淋巴细胞亚群不同,外周血不同类型淋巴细胞亚群对激素最大控制用量的影响不同。Objective：To detect lymphocyte subsets in the peripheral blood of patients with different types of severe drug eruption and study its clinical significance.Methods：Immunofluorescence flow cytometry was performed to analyze the phenotypes of peripheral blood cells in 21 patients with severe drug eruption.Results：CD3＋,CD3＋CD4＋lymphocytes of the peripheral blood in druginduced hypersensitivity syndrome（DIHS） patients was significantly increased in comparison with the normal value,and CD3＋CD4＋lymphocytes of the peripheral blood cells in DIHS patients was significantly higher than that in Stevens-Johnson Syndrome（SJS）patients and toxic epidermal necrolysis（TEN） patients.With the increase in the number of CD3＋CD4＋and CD3＋CD8＋lymphocytes in the peripheral blood cells,the maximum dosage of corticosteroids progressively decreased in SJS and TEN patients.With the increase in the number of CD3-CD16＋CD56＋lymphocytes of the peripheral blood cells,the maximum dosage of corticosteroids progressively increased in SJS and TEN patients.Conclusion：Different types of severe drug eruption have different lymphocyte subsets in the peripheral blood,which have different effects on the maximum dosage of corticosteroids.

关 键 词：淋巴细胞 重症药疹 流式细胞术 治疗 

分 类 号：R758.25[医药卫生—皮肤病学与性病学]