药疹患者外周血单一核细胞中巨细胞病毒的检测

目的 探讨人巨细胞病毒（CMV）感染在药疹发病中的作用。 方法 收集44例药疹患者（其中重型药疹13例）及50例健康对照外周血，Taqman实时荧光定量PCR（RT-PCR）检测外周血单一核细胞中CMV DNA阳性率及载量；酶联免疫吸附试验（ELISA）检测血清CMV IgM阳性率。 结果 44例药疹患者CMV DNA阳性率（65.91%，29/44例）高于健康对照组（28.00%，14/50例），差异有统计学意义（χ2 = 13.552，P < 0.05）；重型药疹患者（11/13例）、轻型药疹患者（58.06%，18/31例）及健康对照组CMV DNA阳性率不完全相等（χ2 = 16.153，P < 0.05），其中重型组高于轻型组（χ2 = 13.817，P < 0.05）及对照组（χ2 = 7.237，P < 0.05）；药疹患者CMV DNA载量（28 183.829 ± 19 527.654）拷贝高于健康对照组（3 019.952 ± 1 760.952）拷贝，差异有统计学意义（t′ = 8.517，P < 0.05），重型药疹患者（554 813.389 ± 722 642.498）拷贝、轻型药疹患者（13 290.558 ± 14 082.356）拷贝与对照组间CMV DNA载量差异无统计学意义（P > 0.05）。药疹患者CMV IgM阳性率（13.64%，6/44例）与健康对照组（6.00%，3/50例）差异无统计学意义（P > 0.05）；轻型药疹（6.45%，2/31例）、重型药疹（4/13例）及健康对照组各组均数不完全相等（χ2 = 7.832，P < 0.05），其中重型组高于对照组（χ2 = 6.409，P < 0.05）。 结论 药疹患者存在CMV感染，CMV感染可能是药疹发病或加重的因素之一。

Detection of cytomegalovirus in peripheral blood mononuclear cells of patients with drug eruptions

Li Shuanggeng, Chen Guanzhi *, Xiao Jungang, Wang Jun, Pan Min. *Department of Dermatology, Affiliated Hospital of Qingdao University Medical College, Qingdao 266003, ChinaCorresponding author: Chen Guanzhi, Email: chenguanzhi@outlook.com 【Abstract】 Objective To investigate the role of human cytomegalovirus （CMV） in the occurrence of drug eruptions. Methods Peripheral blood samples were collected from 44 patients with drug eruptions （including 13 severe cases） and 50 healthy human controls. Taqman fluorescent real-time quantitative PCR （RT-PCR） was performed to determine the positive rate and load of CMV DNA in peripheral blood mononuclear cells （PBMCs）. Enzyme-linked immunosorbent assay （ELISA） was conducted to detect anti-CMV IgM antibodies in sera. Results The positive rate of CMV DNA was significantly higher in the patients than in the controls （65.91 % （29/44） vs. 28.00 % （14/50）, χ2 = 13.552, P < 0.05）, significantly different among patients with severe drug eruptions （11/13）, patients with mild drug eruptions （58.06% （18/31）） and the controls （χ2 = 16.153, P < 0.05）. In addition, patients with severe drug eruptions showed a higher positive rate of CMV DNA compared with patients with mild drug eruptions （χ2 = 13.817, P < 0.05） and the controls （χ2 = 7.237, P < 0.05）. CMV DNA load was significantly higher in the patients than in the controls （（28 183.829 ± 19 527.654） vs. （3 019.952 ± 1 760.952） copies, t′ = 8.517, P < 0.05）. No significant difference was found in CMV DNA load between patients with severe drug eruptions （（554 813.389 ± 722 642.498） copies）, patients with mild drug eruptions （（13 290.558 ± 14 082.356） copies）） and the controls （P > 0.05）. The positive rate of anti-CMV IgM antibodies was similar between the patients and controls （13.64% （6/44） vs. 6.00% （3/50）, P > 0.05）, but significantly different among patients with severe drug eruptions （4/13）, patients with mild drug eruptions （6.45%, 2/31） and the controls （χ2 = 7.832, P < 0.05）, and significantly higher in patients with severe drug eruptions than in the controls （χ2 = 6.409, P < 0.05）. Conclusions CMV infection exists in patients with drug eruptions, and might be a factor associated with the initiation and aggravation of drug eruptions.