抗癫痫药物皮肤不良反应与HLA-B*1502基因的相关性研究  

The Correlation Study of the Aromatic Antiepileptic Drug Induced Cutaneous Adverse Drug Reactions and HLA-B*1502 Gene

作　　者：王蕊艳[1] 蔡兰云[1] 付丽琴[1] 

机构地区：[1]江西省儿童医院,江西南昌330006

出　　处：《中国医学创新》2014年第34期20-22,共3页Medical Innovation of China

基　　金：江西省卫生厅科技支撑计划课题(20133140)

摘　　要：目的:探讨江西省汉族人群中芳香族抗癫痫药物所致皮肤不良反应与HLA-B*1502基因的相关性。方法:采用病例对照研究,一共收集样本46例,其中Stevens-Johnson综合征(SJS)组13例,轻微皮肤反应(MPE)组19例,对照组(包括耐受者和正常志愿者)14例。采用序列特异性引物聚合酶链反应(SSPPCR)技术检测HLA-B*1502的基因型。采用Fisher确切概率法检验分析HLA-B*1502与抗癫痫药物皮肤不良反应的相关性。结果:HLA-B*1502基因频率分别为SJS组100%(13/13),MPE组10.5%(2/19),对照组7.1%(1/14)。SJS组分别与MPE组和对照组比较差异具有统计学意义(P<0.05),MPE组与对照组比较差异无统计学意义(P<0.05)。结论:江西汉族人群中芳香族AEDs导致的SJS与HLA-B*1502基因具有强相关性,而MPE与之无相关性。建议江西汉族人群在采用AEDs治疗前应该进行HLA-B*1502基因型检测,阳性者应避免服用芳香族AEDs,此外还需警惕阴性者发生SJS等严重皮肤不良反应。Objective： To investigate the correlation between the aromatic antiepileptic drugs（AEDs） induced cutaneous adverse drug reactions（c ADRs） and HLA-B＊1502 gene in Han population of Jiangxi province. Method： The case-control study was taken, A total of 46 cases of samples were collected, including 13 patients with Stevens-Johnson syndrome（SJS）（SJS group）, 19 patients with mild skin reaction（MPE）（MPE group）, and 14 tolerance and normal volunteers as controls（control group）.The sequence-specific primers polymerase chain reaction（SSP-PCR） technique was used to detect HLA-B＊1502 genotype. The Fisher＇s exact test was used to analyze the correlation between HLAB＊1502 and AEDs-c ADRs. Result： The gene frequencies of HLA-B＊1502were 100%（13/13） in SJS group, 10.5%（2/19） in MPE group and 7.1%（1/14） in the control group. There were significant differences in the SJS group compared with MPE group and the control group（P0.05）, there was no statistically significant difference between the MPE group and the control group（P0.05）. Conclusion： There is a strong correlation between HLA-B＊1502 gene and the aromatic AEDs-induced SJS,but the correlation between HLA-B＊1502 gene and MPE has not been found in Han population of Jiangxi province. HLA-B＊1502 gene type testing before initiating AEDs therapy is suggested for Han population of Jiangxi province. Those with positive HLA-B＊1502 should avoid taking aromatic AEDs. Furthermore,physicians should also be vigilant about SCR,such as SJS,in those with negative HLA-B＊1502.

关 键 词：抗癫痫药 皮肤不良反应 HLA-B＊1502 江西汉族人群 

分 类 号：R742.1[医药卫生—神经病学与精神病学]