藥疹患者臨床特征分析及補(bǔ)體系統(tǒng)異常活化的探討

于均峰++尚佩生+++張文娟++沈曉峰

[摘要] 目的 了解近年烏魯木齊市藥疹患者的臨床特征，檢測不同類型藥疹患者及健康對照者血清中IgG、IgE、IgA、C3、C4、CIC水平，初步探討補(bǔ)體系統(tǒng)活化在在藥疹發(fā)病機(jī)制中的作用。 方法 收集2013年12月～2015年12月新疆醫(yī)科大學(xué)第一、第五附屬醫(yī)院皮膚科病房62例藥疹患者，包括52例輕型藥疹患者（藥物性皮炎組）及10例重癥藥疹患者（重癥藥疹組），并選擇新疆醫(yī)科大學(xué)第五附屬醫(yī)院體檢中心健康人群30名作為健康對照組。采集上述藥疹患者急性期血清以及對照人群血清，采用酶聯(lián)免疫吸附試驗(yàn)（ELISA）檢測血清中IgG、IgE、IgA、C3、C4、CIC濃度。 結(jié)果 引起藥疹的致敏藥中抗生素所占比例最大，共有32例，約占總數(shù)的51.61%；其次為中藥注射劑，共有18例，占29.03%。兩組藥疹患者的血清IgG水平均低于健康對照組（P < 0.05），IgE含量均高于健康對照組（P < 0.05），而且重癥藥疹組患者入院時(shí)IgE水平高于藥物性皮炎組（P < 0.05）。藥疹患者血清中C3含量低于健康對照組，CIC含量高于健康對照組，而且重癥藥疹組入院時(shí)CIC含量高于藥物性皮炎組，差異均有統(tǒng)計(jì)學(xué)意義（P < 0.05）。 結(jié)論 補(bǔ)體系統(tǒng)的異常活化尤其是C3的消耗及CIC的沉積在藥疹的發(fā)病機(jī)制中具有一定意義。

[關(guān)鍵詞] 藥疹；補(bǔ)體系統(tǒng)；致敏藥物

[中圖分類號] R758 [文獻(xiàn)標(biāo)識碼] A [文章編號] 1673-7210（2017）04（b）-0115-04

[Abstract] Objective To investigate the clinical characters of patient with drug eruption， detect the serum levels of IgG， IgE， IgA， C3， C4 and CIC in the patients and healthy control， preliminary discuss the role of complement system in pathogenesis of drug eruption. Methods 62 patients with drug eruption in Dermatology Wards of the First Affiliated Hospitals of Xinjiang Medical University and the Fifth Affiliated Hospitals of Xinjiang Medical University from December 2013 to December 2015 were selected， including 10 patients with severe drug eruption （severe drug eruption group）， and 52 patients with mild drug eruption （dermatitis medicamentosa group）. At the same time 30 healthy controls in Physical Examination Center of the Fifth Affiliated Hospitals of Xinjiang Medical University were selected as the healthy control group. The serum of acute stage patients and healthy controls were collected. The levels of IgG， IgE， IgA， C3， C4 and CIC in serum were determined by enzyme-linked immunosorbent assay. Results Antibiotics was the main sensitizer in drug eruption， the proportion was 51.61% （32 cases）. The second sensitizer was traditional Chinese medicine preparation， the proportion was 29.03% （18 cases）. Serum levels of IgG in patients with drug eruption were lower than those in the healthy control group （P < 0.05）， while levels of IgE were higher than those in the healthy control group （P < 0.05）， and level of IgE in patients at admission of the severe drug eruption group was higher than that in the dermatitis medicamentosa group （P < 0.05）. The levels of C3 in patients with drug eruption were lower than those in the healthy control group， levels of CIC were higher than those in the healthy control group， and level of CIC in patients at admission of the severe drug eruption group was higher than that in the dermatitis medicamentosa group， with statistically significant differences （P < 0.05）. Conclusion The abnormal activation of complement system especially the consumption of C3 and deposition of CIC may play an important role in the pathogenesis of drug eruption.