别嘌呤醇引起发疹型药疹8例及相关基因HLA-B＊ 5801检测  

Allopurinol-Induced Exanthematous Drug Eruption in Eight Patients and Their HLA-B* 5801 Genotype Detection

作　　者：罗阳[1,2] 韩悦[1,2] 王宝玺[1,2] 姚煦[1,2] 刘军[1] 

机构地区：[1]南京大学医学院附属鼓楼医院皮肤性病科,南京210008 [2]中国医学科学院,北京协和医学院,皮肤病研究所,江苏省皮肤病与性病学重点实验室,南京210042

出　　处：《中华临床免疫和变态反应杂志》2016年第2期87-90,186,共5页Chinese Journal of Allergy & Clinical Immunology

摘　　要：目的通过检测8例别嘌呤醇引起的发疹型药疹患者的HLA-B＊5801等位基因,探讨别嘌呤醇引起的发疹型药疹与HLA-B＊5801等位基因的相关性。方法收集本院2012年3月至2015年5月因别嘌呤醇所致的发疹型药疹患者8例,服用别嘌呤醇未发生药疹痛风患者30例,健康体检者120名。采集患者外周静脉血,提取DNA,利用PCR技术检测受试者HLA-B＊5801基因型。结果 8例别嘌呤醇引起发疹型药疹患者中,3例患者HLA-B＊5801等位基因阳性,阳性率为37.5%;30例服用别嘌呤醇未发生药疹的痛风患者中,2例患者HLA-B＊5801等位基因阳性,阳性率为6.7%;120名健康受试者中,13名HLA-B＊5801等位基因阳性,阳性率为10.8%。各组间比较差异无统计学意义（χ2=4.931,P〉0.05）。药疹组与非药疹组HLA-B＊5801基因阳性率的比值比OR=8.400（95%CI：1.107～63.735,P〈0.05）;药疹组与健康体检组HLA-B＊5801基因阳性率的比值比OR=4.938（95%CI：1.056～23.100,P〈0.05）。结论别嘌呤醇引起发疹型药疹患者HLA-B＊5801等位基因阳性率与对照组比较差异没有统计学意义,但与HLA-B＊5801的基因携带具有相关性。Objective To evaluate the correlation between allopurinol-induced exanthematous drug eruption and HLA-B＊ 5801 allele based on the detection of the HLA-B ＊ 5801 allele among eight cases of patients.Methods Eight patients with allopurinol-induced exanthematous drug eruption were collected from Nanjing Drum Tower Hospital since March 2012 to May 2015,30 cases of allopurinol-tolerant patients who had taken allopurinol for three months without any drug eruption and 120 healthy controls were also enrolled in this study. Peripheral venous blood samples were collected and DNA samples were extracted. HLA-B＊ 5801 genotype was analyzed by using q PCR technique. Results HLA-B 5801 positive results were shown among three patients（ 37. 5%） with allopurinol-induced exanthematous drug eruption,two cases（ 6. 7%） among allopurinol-tolerant patients,and 13 individuals（ 10. 8%） among healthy controls. There was no statistical difference significantly among the HLA-B＊ 5801 allele frequency of three groups（ χ2= 4. 931,P〈 0. 05）.The odds ratio（ OR） value of HLA-B＊ 5801 allele frequency between drug eruption group and allopurinoltolerant group was 8. 400（ 95% CI： 1. 107-63. 735, P〈 0. 05）,whereas 4. 938（ 95% CI： 1. 056-23. 100,P〈 0. 05） between drug eruption group and healthy control group. Conclusion There is significant correlation between HLA-B＊ 5801 allele and allopurino1-induced exanthematous drug eruption,while there was no statistical difference significantly among the HLA-B ＊ 5801 allele frequency of three groups.

关 键 词：别嘌呤醇 发疹型药疹 HLA-B＊5801 

分 类 号：R758.25[医药卫生—皮肤病学与性病学]