复方磺胺甲噁唑诱发HIV感染者超敏反应相关因素分析  

The related factors of hypersensitivity induced by 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]南通市第三人民医院感染科,南通市226006

出　　处：《中华实验和临床感染病杂志（电子版）》2015年第6期21-24,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：南通市社会事业创新与示范计划项目(No.HS2014084);南通市卫生局青年基金项目(No.WQ2014035)

摘　　要：目的探讨HIV感染者服用复方磺胺甲噁唑(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,对74例HIV感染并服用Co-SMZ患者的年龄、性别、入院时HIV发现的时间间隔、CD3^+T细胞、CD4^+T细胞、CD8^+T细胞、NK细胞计数以及合并用药情况进行分析,探明可能诱发Co-SMZ相关超敏反应的因素。入组患者中,治疗性使用Co-SMZ患者56例;预防性使用CoSMZ患者18例。结果在发生超敏反应和未发生超敏反应人群中,性别、年龄的分布、入院时与发现HIV感染时间间隔、CD3^+T细胞、CD8^+T细胞计数,联合使用哌拉西林他唑巴坦、头孢他啶、头孢吡肟、亚胺培南西司他丁、替考拉宁、氟康唑、甲泼尼龙、抗HIV药物以及Co-SMZ使用剂量等方面差异均无统计学意义(P均>0.05);CD4^+T细胞、NK细胞表达水平计数,联合使用莫西沙星例数在两组患者差异有统计学意义(P<0.05);CD4^+T细胞、NK细胞能预测Co-SMZ相关超敏反应的发生(Z=2.872、2.836,P均<0.05)。结论在HIV感染者中,Co-SMZ诱发超敏反应的发生可能与CD4^+T细胞、NK细胞计数以及是否合并使用莫西沙星有关。Objective To investigate the related factors of hypersensitivity induced by compound sulfamethoxazole（Co-SMZ） in patients with human immunodeficiency virus（HIV） infection.Methods Total of 74 patients receiving Co-SMZ with HIV infection were enrolled in the study.The age,gender,interval time from finding HIV infection to hospitalization,the count of CD3^＋ T cell,CD4^＋ T cell,CD4^＋T cell and NK cell,and the combined drugs were analyzed,respectively.Retrospective method was taken in the study.There were 56 patients with Co-SMZ treatment and 18 patients with preventive use.Results There were no significant differences in the age,gender,interval time from finding HIV infection to hospitalization,the count of CD3^＋ T cell,CD4^＋ T cell,combined of piperacillin tazobactam,ceftazidime,cefepime,imipenem-cilastatin,teicoplanin,fluconazole,methyl prednisolone or the anti-HIV drugs,the dose of Co-SMZ between patients with Co-SMZ related hypersensitivity and patients without Co-SMZ related hypersensitivity（P all 〉0.05）.Significant difference was found in the count of CD4^＋ T cell,NK cell and moxifloxacin in combination among the two groups（P 〈0.05）.The count of CD4^＋ T cell,NK cell could predict the occurrence of hypersensitivity induced by Co-SMZ（Z = 2.872,2.836;P all 〈0.05）.Conclusions Among patients with HIV infection,the count of CD4^＋ T cell,NK cell and moxifloxacin in combination might be associated with the hypersensitivity induced by Co-SMZ.

关 键 词：人类免疫缺陷病毒 复方磺胺甲噁唑 超敏反应 

分 类 号：R512.91[医药卫生—内科学]