HLA-B*58:01與別嘌醇皮膚不良反應關聯性研究

To investigate the relationship between HLA-B*58:01 and allopurinol-induced skin adverse reactions

10.12408/J.issn2223-4462.2024.01.010

鄧雲春(TANG Wan Chon)；劉穎(LIU Ying)

HLA-B*58:01等位基因 ； 别嘌醇 ； 皮膚不良反應 ； HLA-B*58:01 allele ； Allopurinol ； Skin adverse reactions

鏡湖醫學

24卷1期（2024 / 06 / 01）

32 - 33+90

繁體中文;英文

目的：了解鏡湖醫院病人檢測HLA-B*58:01等位基因情況，以及與别嘌醇誘導的皮膚不良反應的相關性。方法：採用回顧性分析方法，調查2021年11月～2022年6月開立HLA-B*58:01基因檢驗項目患者的藥物過敏史及用藥史等情況，應用統計軟件進行數據處理和分析。結果：期間接受檢驗病人131例，21例（16%）檢驗結果為陽性。曾服用别嘌醇的病人中HLA-B*58:01基因陽性組發生皮膚不良反應3例（50%），HLA-B*58:01陰性組只有2例（3.6%），差異具有統計學意義（P<0.05）。結論：檢測HLA-B*58:01等位基因攜帶率16%，HLA-B*58:01等位基因與别嘌醇所致皮膚不良反應具有顯著相關性，建議在開始使用别嘌醇之前應先進行檢測。並且使用較低初始劑量，用藥期間對腎功能進行評估，以盡量減低嚴重皮膚不良反應發生的風險。

Objective: To survey the carrier status of HLA-B*58:01 allele in patients in Kiang Wu Hospital (hereinafter referred to as our hospital) and its correlation with Allopurinol-induced skin adverse reactions. Methods: A retrospective analysis method was used to investigate the drug allergy history and medication history of patients who were prescribed the HLA-B*58:01genetic test item from November 2021 to June 2022.The basic data and HLA-B*58:01 gene of the above patients were analyzed by statistical software. Results: During the period, 131 patients were tested, and 21 patients (16%) had positive test results. Among patients who had taken allopurinol, there were 3 cases (50%) of adverse skin reactions in HLA-B*58:01 gene positive group, and only 2 cases (3.6%) in HLA-B*58:01 negative group. Conclusion: In view of 16% of HLA-B*58:01 allele in our hospital, and the results of the study showed a significant correlation between HLA-B*58:01 gene and Allopurinol-induced skin adverse reactions. It is suggested that detection should be performed before starting Allopurinol use. With a lower initial dose of Allopurinol, renal function should be assessed during treatment to minimize the risk of serious skin adverse reactions.