别嘌醇所致严重皮疹与HLA-B*5801等位基因的相关性  

Correlation between allopurinol-induced severe rash and HLA-B*5801 allele

作　　者：关灵[1] 刘碧波[1] 廖玉婷[1] 江丽华[1] 

机构地区：[1]东莞市人民医院,523059

出　　处：《中国现代药物应用》2016年第5期7-8,共2页Chinese Journal of Modern Drug Application

摘　　要：目的探讨服用别嘌醇后发生严重皮疹与人类白细胞抗原(HLA)-B*5801等位基因之间的相关性。方法 12例服用别嘌醇后发生严重皮疹的患者作为别嘌醇皮疹组,17例服用别嘌醇后6个月未发生严重皮疹的患者作为别嘌醇对照组,15例健康志愿者作为健康组,采用序列特异性引物引导的聚合酶链反应与直接测序方法分别对三组研究对象的外周静脉血进行HLA-B*5801等位基因检测,分析严重皮疹的发生与HLA-B*5801等位基因之间的联系。结果别嘌醇皮疹组的HLA-B*5801等位基因阳性率为91.67%(11/12),别嘌醇对照组的HLA-B*5801等位基因阳性率为5.88%(1/17),健康组的HLAB*5801等位基因阳性率为13.33%(2/15),别嘌醇皮疹组HLA-B*5801等位基因阳性率明显高于其他两组,差异有统计学意义(P<0.05)。HLA-B*5801等位基因阳性者服用别嘌醇后发生严重皮疹的风险显著高于阴性者。结论 HLA-B*5801等位基因阳性者服用别嘌醇后发生严重皮疹的风险非常高,用药前需行HLA-B*5801等位基因筛查以减少皮疹的发生,提高用药安全。Objective To investigate correlation between allopurinol-induced severe rash and human leucocyte antigen（HLA）-B＊5801 allele. Methods There were 12 patients with allopurinol-induced severe rash as allopurinol rash group, another 17 patients without severe rash after 6-month administration of allopurinol as allopurinol control group, and 15 healthy volunteers as healthy group. Sequence specific primer-guided polymerase chain reaction and direct sequencing were applied to detect HLA-B＊5801 allele in peripheral venous blood of the three groups, so as to analyze correlation between severe rash and HLA-B＊5801 allele. Results The allopurinol rash group had positive rate of HLA-B＊5801 allele as 91.67%（11/12）, the allopurinol control group had that as 5.88%（1/17）, and the healthy group had that as 13.33%（2/15）. The allopurinol rash group had obviously higher positive rate of HLA-B＊5801 allele than the other two groups, and their difference had statistical significance（P〈0.05）. Patients with positive HLA-B＊5801 allele had obviously higher risk of severe rash after administration of allopurinol than those with negative HLA-B＊5801 allele. Conclusion Occurrence of severe rash shows high risk in patients with positive HLA-B＊5801 allele after administration of allopurinol. Thus HLA-B＊5801 allele screening before administration is necessary to reduce occurrence of rash and improve medication safety.

关 键 词：别嘌醇 皮疹 人类白细胞抗原 

分 类 号：R758.25[医药卫生—皮肤病学与性病学]