140例癫痫患儿HLA-B~* 1502基因检测分析及用药风险评估被引量：8

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摘要目的研究HLA-B~*1502等位基因型在上海地区癫痫患儿中分布情况,对HLA-B~*1502阳性患儿使用奥卡西平诱发Stevens-Johnson综合征(SJS)和中毒性表皮坏死松解(TEN))的风险进行评估。方法选取2014—2016年上海市儿童医院神经内科住院就诊初次使用抗癫痫药物(AEDs)且使用前进行HLA-B~*1502基因检测和用药指导的患儿140例,采用荧光染色原位杂交测序技术检测HLA-B~*1502的HLA-B~*1502TA(C>G)与HLA-B~*1502TB(C>T)两个基因位点的基因型,分析其基因型与SJS/TEN发生情况。结果检测140例初次使用AEDs癫痫患儿的HLA-B~*1502TA(C>G),HLA-B~*1502TB(C>T)基因型,阴性89例(占63.57%),阳性51例(占36.43%)。所有阳性结果患儿避免使用卡马西平,使用奥卡西平后未发生SJS/TEN。结论有必要对初次服用AEDs的癫痫患儿进行HLA-B~*1502基因检测,该检测可以帮助临床评估癫痫患儿重症皮肤不良反应风险。对于HLA-B~*1502阳性患者,应避免使用卡马西平,可以使用奥卡西平,但仍有一定风险,需在使用的最初3个月内严密观察皮肤不良反应。荧光染色原位杂交测序在临床用药前检测中快速有效,适合医院药学。该研究结论仍需要在今后的研究中扩大样本量进一步验证。

作者孟琳懿王春梅姜志虎李志玲孙华君黄建军

机构地区上海市儿童医院、上海交通大学附属儿童医院神经内科

出处《医药导报》 CAS 北大核心 2018年第11期1409-1411,共3页 Herald of Medicine

基金上海交通大学医学院医院药学科研基金重点项目(JDYX2016ZD005) 上海市卫生和计划生育委员会青年项目(20154Y0019)

关键词奥卡西平卡马西平癫痫GFEB6 人类白细胞抗原基因型

分类号 R969 [医药卫生—药理学] R748 [医药卫生—神经病学与精神病学]

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