人类免疫缺陷病毒感染者预防性服用复方磺胺甲唑发生超敏反应的相关因素分析  

Risk factors of hypersensitivity induced by prophylactic compound sulfamethoxazole in patients with human immunodeficiency virus infection

作　　者：邹美银[1] 凌勇武[1] 汪美华[1] 朱勇根[1] 张健荣[1] 

机构地区：[1]江苏省南通市第三人民医院感染科,226006

出　　处：《中华传染病杂志》2015年第5期286-289,共4页Chinese Journal of Infectious Diseases

基　　金：南通市社会事业创新与示范计划项目(HS2014084)；南通市卫生局青年基金项目

摘　　要：目的：探讨 HIV 感染者服用复方磺胺甲唑（Co-SMZ）后诱发超敏反应的可能因素。方法采用回顾性研究的方法，收集2014年1月至11月就诊于江苏省南通市第三人民医院感染病科111例 HIV 感染者的年龄、性别、入院至确诊 HIV 感染的时间、既往药物超敏反应情况、服用 Co-SMZ当天外周静脉血 CD3＋ T 淋巴细胞、CD4＋ T 淋巴细胞、CD8＋ T 淋巴细胞、NK 细胞计数等资料，随访时间至服用 Co-SMZ 后2个月。正态分布或近似正态分布的计量资料采用 t 检验，偏态分布计量资料采用秩和检验，计数资料采用卡方检验。结果入组111例 HIV 感染者中，男107例，女4例，平均年龄（45．7±11．1）岁，预防性服用 Co-SMZ 的 HIV 感染者发生超敏反应时间为（14．0±7．6）d。CD4＋ T 淋巴细胞、NK 细胞表达水平在发生超敏反应组与未发生超敏反应组之间差异均有统计学意义（均 P ＜0．05）。多因素分析发现，NK 细胞与 Co-SMZ 诱发超敏反应相关（OR ＝1．010，95％CI ：1．005～1．017， P ＝0．001）。NK 细胞预测 Co-SMZ 诱发超敏反应的受试者工作特征（ROC）曲线下面积为0．748（95％CI ：0．647～0．850，Z ＝4．701，P ＝0．001），最佳预测值为109．80／μL，灵敏度为63．2％，特异度为84．7％。结论在 HIV 感染患者中，Co-SMZ 诱发的超敏反应可能与 NK 细胞计数有关。Objective To investigate the risk factors of hypersensitivity induced by compound sulfamethoxazole （Co-SMZ）in patients with human immunodeficiency virus （HIV）infection.Methods A retrospective study was performed in 111 patients with HIV infection receiving prophylactic Co-SMZ at the Department of Infectious Diseases,the Third People′s Hospital of Nantong City,Jiangsu Province from January 2014 to December 2014.Data including age,gender,interval time from diagnosis of HIV infection to hospitalization,history of drug allergy,and the counts of CD3 ＋ T cell,CD4 ＋ T cell,CD8 ＋ T cell and natural killer （NK）cell on the day when the medicine was administrated for the first time were recorded. All the patients were followed up for two months.Student t test was used in data with normal distribution or approximate normal distribution.Rank sum test was used in data with skew distribution.The count materials were examined byχ2 test.Results Among the 111 patients with HIV infection,there were 107 males and 4 females with average age of （45 .7±11 .1）years old.The interval time from taking Co-SMZ to hypersensitivity was （14.0±7.6）d.There were differences in the counts of CD4 ＋ T cell and NK cell between patients with hypersensitivity and without hypersensitivity （both P 〈0.05）.Multivariate analysis showed that NK cell was a risk factor for inducing hypersensitivity （OR=1 .010,95 %CI ：1 .005 -1 .017, P =0.001）.The area under of receiver operating characteristic curve predicting hypersensitivity induced by Co-SMZ was 0.748 （95 %CI ：0.647-0.850,Z =4.701 ,P =0.001）.The best predictor was 109.80/μL with sensitivity of 63.2% and specificity of 84.7%.Conclusion In patients with HIV infection,NK cell might be associated with hypersensitivity induced by Co-SMZ.

关 键 词：HIV 复方磺胺甲嚼唑 超敏反应 

分 类 号：R512.91[医药卫生—内科学]