重症药疹患者体液免疫指标与炎症因子的相关性分析 |
| 陈 倩 ，胡熙曦 |
| 1. 宜昌市第三人民医院皮肤科，湖北 宜昌 443003；2. 宜昌市第二人民医院药剂科，湖北 宜昌 443000 |
Humoral immune markers and infl ammatory factors in patients with severe cutaneous adversedrug reactions (SCADRs):a retrospective and correlative study |
| CHEN Qian , HU Xi-xi |
| 1.Dermatological department,Yichang Third People‘s Hospital,Yichang,Hubei 443003,China;2.Department of pharmacy,YichangSecond People‘s Hospital,Yichang,Hubei 443000,China |
| 摘要 |
[目的] 目的 通过分析重症药疹患者体液免疫和炎症因子指标，探讨免疫球蛋白（Immunoglobin,Ig）及补体（Complements,C）与 C 反应蛋白（C-reactive protein,CRP）和降钙素原（Procalcitonin,PCT）的相关性。方法 选取 2015 年 1 月至 2019 年 12 月某医院收治资料完整的重症药疹患者、固定型药疹患者和同期体检健康人群各 45 例，采用免疫散射比浊法检测血清中 IgG、IgA、IgM、C 3 、C 4 、CRP 水平及酶联荧光分析法检测同期血清 PCT 水平。结果 重症药疹组、固定型药疹组及健康组间的年龄、性别构成比的水平差异无统计学意义（P ＞ 0.05）；IgA、IgM、C 3 及 C 4 水平在重症药疹组与固定型药疹组间差异无统计学意义（P ＞0.05）。IgG、IgA、IgM、C 3 及 C 4 水平在重症药疹组中较健康组均显著降低，并且 IgG 在重症药疹组中较固定型药疹组降低，差异均具有统计学意义（P ＜ 0.05）；CRP 及 PCT 在重症药疹组中较固定型药疹组及健康组均显著升高，差异均具有统计学意义（P ＜0.05）。重症药疹组患者 IgG、IgA、IgM、C 3 、C 4 、CRP 水平与 PCT 均无显著相关性（P ＞ 0.05）；重症药疹组患者 IgG、IgA、IgM、C 4 水平与 CRP 均无显著相关性（P ＞ 0.05），而 C 3 水平与 CRP 呈正相关（P ＜ 0.05）。结论 重症药疹患者在发病过程中出现体液免疫功能指标水平降低及炎症因子水平升高，且血清 CRP 的升高与 C 3 水平关系密切。 |
| 关键词 |
药疹 ; 免疫球蛋白 ; 补体 ; C 反应蛋白 ; 降钙素原 |
| Abstract： |
Objective Humoral immune markers and infl ammatory factors (C-reactive protein, CRP and procalcitonin, PCT) in patients with SCADRswere examined to explore the possible role of humoral immunity involved in the pathogenesis of drug eruption, and its correlation with CRP and PCT.Methods In this study, 45 cases in each group of SCADRs patients, fi xed drug eruption patients and healthy controls in the same period were enrolledfrom January 2015 to December 2019. Serum IgG，IgA，IgM，C 3 ，C 4 ，CRP were detected by using immunoscattering turbidimetric assay，meanwhile，serum PCT was measured by using enzyme-linked fl uorescence analysis assay. Results The differences of age and gender ratio were not statisticallysignifi cant between SCADRs group, fi xed drug eruption group and the healthy group (all P ＞ 0.05); The differences of serum IgA, IgM, C 3 ,and C 4 werenot statistically signifi cant between SCADRs group and fi xed drug eruption group(all P ＞ 0.05). Serum IgG, IgA, IgM, C 3 ,and C 4 in SCADRs groupwere signifi cantly decreased than those in health controls，and IgG in SCADRs group were signifi cantly lower than that in the fi xed drug eruption group,which demonstrated statistically signifi cant (all P ＜ 0. 05). Furthermore, Serum CRP and PCT in SCADRs group were signifi cantly increased than thosein fi xed drug eruption group and health controls, which demonstrated statistically signifi cant (all P ＜ 0. 05). There were no statistically signifi cant cor-relation between serum IgG， IgA， IgM，C 3 ，C 4 and PCT (all P ＞ 0. 05) in SCADRs group. And there were no statistically signifi cant correlation betweenserum IgG，IgA，IgM，C 4 and CRP (all P ＞ 0. 05) in SCADRs group. However，it was so interesting that there was a signifi cant positive correlation be-tween serum C 3 and CRP in SCADRs group. Conclusion In patients with SCADRs, the level of humoral immune function index decreased and the level ofinfl ammatory factors increased, and the increase of serum CRP was closely related to the level of C 3. |
| Keywords |
Drug eruption ; Immunoglobulin ; Complement ; C-reactive protein ; Procalcitonin |
| 参考文献 |
［1］ 蔡艳霞 , 马萍萍 , 李定 .52 例重症药疹患者临床分析 [J]. 皮肤性病诊疗学杂志 ,2020,27(2):108-111.
［2］ Bolognia J L,Schaffer J V,Cerrono L . 皮肤病学 [M]. 朱学骏 , 王宝玺 ,孙建方 , 等译 .4 版 . 北京 : 北京大学医学出版社 ,2019:396.
［3］ Guvenir H,Arikoglu T,Vezir E,et al.Clinical phenotypes of severe cu-taneous drug hypersensitivity reactions[J]. Curr Pharm Des,2019,25(36):3840-3854.
［4］ Duong T A,Valeyrie-allanore L,Wolkenstein P,et al.Severe cutaneousadverse reactions to drugs[J].Lancet,2017,390(10106):1996-2011.
［5］ Giang J,Seelen M A J,Van D M B A,et al.Complement activation ininfl ammatory skin diseases[J].Front Immunol,2018(9):639.
［6］ Kotnik V.Complement in skin diseases[J].Acta Dermatovenerol AlpPanonica Adriat,2011,20(1):3-11.
［7］ 秦杰 , 单仁飞 , 叶一冰 , 等 . 血清降钙素原与 C- 反应蛋白水平检测对患者早期感染的诊断 [J]. 中华医院感染学杂志 ,2015,25(2):271-275.
［8］ Bador K M,Intan S,Hussin S,et al.Serum procalcitonin has negativepredictive value for bacterial infection in active systemic lupus ery-thematosus[J].Lupus,2012,21(11):1172-1177.
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