體外檢測(cè)藥疹患者致敏藥物的動(dòng)物實(shí)驗(yàn)
發(fā)布時(shí)間:2018-05-21 08:35
本文選題:藥疹 + 致敏藥物 ; 參考:《河北醫(yī)科大學(xué)》2010年碩士論文
【摘要】: 目的:藥物通過(guò)注射內(nèi)服吸入等途徑進(jìn)入人體后引起的皮膚粘膜反應(yīng)稱為藥疹。藥物引起的不良反應(yīng)非常復(fù)雜,大致可以分藥物過(guò)量不耐受性特發(fā)性副作用繼發(fā)作用及過(guò)敏反應(yīng)等,藥疹是過(guò)敏反應(yīng)最常見(jiàn)的類型。在臨床上應(yīng)用多種藥物進(jìn)行治療的病人發(fā)生藥物過(guò)敏,當(dāng)這種病人不能停藥時(shí),可以通過(guò)動(dòng)物實(shí)驗(yàn)來(lái)檢測(cè)此種病人對(duì)何種藥物過(guò)敏,從而停止該藥物,而不停用其他藥物,從而不延誤病人的治療。但藥疹的實(shí)驗(yàn)分為皮膚實(shí)驗(yàn)和實(shí)驗(yàn)室試驗(yàn),兩者都不完善。本實(shí)驗(yàn)就是通過(guò)已明確何種藥物致敏的患者的血清注射到動(dòng)物局部,通過(guò)注射后引起的全身反應(yīng)和局部反應(yīng)為動(dòng)物實(shí)驗(yàn)檢測(cè)藥疹患者致敏藥物提供參考。本實(shí)驗(yàn)所用動(dòng)物是小鼠,通過(guò)小鼠局部注射后引起的全身反應(yīng)和局部反應(yīng)來(lái)完成本實(shí)驗(yàn),為臨床提供參考以克服傳統(tǒng)激發(fā)試驗(yàn)所帶來(lái)的危險(xiǎn)性。 方法:本實(shí)驗(yàn)是通過(guò)藥疹患者的血清注入小鼠背部局部皮下,24,48小時(shí)后局部注入藥疹患者的致敏藥物,試驗(yàn)組小鼠出現(xiàn)全身反應(yīng)和局部反應(yīng)的陽(yáng)性率較高,而對(duì)照組陽(yáng)性率較低。通過(guò)試驗(yàn)組和對(duì)照組比較來(lái)為動(dòng)物實(shí)驗(yàn)檢測(cè)藥疹患者何種藥物致敏提供參考。藥疹患者15例均來(lái)自河北醫(yī)科大學(xué)第三醫(yī)院皮膚科,時(shí)間是2009年3月到2009年12月。這些藥疹患者均經(jīng)過(guò)詳細(xì)詢問(wèn)用藥史,并且反復(fù)發(fā)生該藥物過(guò)敏。其中有5例是來(lái)自其他科室用藥過(guò)程中發(fā)生過(guò)敏并且激發(fā)試驗(yàn)也證明對(duì)此藥過(guò)敏。其中有2例司帕沙星過(guò)敏,2例左氧氟沙星過(guò)敏,1例二甲雙呱過(guò)敏,1例青霉素類過(guò)敏,1例磺胺藥物過(guò)敏,8例解熱鎮(zhèn)痛藥過(guò)敏。小鼠均來(lái)自河北醫(yī)科大學(xué)動(dòng)物實(shí)驗(yàn)中心,小鼠隨機(jī)分組進(jìn)行背部局部皮下注射,對(duì)照組是采用藥疹患者血清注入小鼠背部局部皮下,24,48小時(shí)后局部再注射生理鹽水。觀察局部反應(yīng)和全身反應(yīng),進(jìn)行對(duì)照組和試驗(yàn)組對(duì)比。試驗(yàn)組和對(duì)照組均取局部組織進(jìn)行普通HE染色,再進(jìn)行鏡檢。最后對(duì)局部反應(yīng)和全身反應(yīng)進(jìn)行評(píng)分。 過(guò)敏反應(yīng)癥狀:0正常,1躁動(dòng),2豎毛,3顫抖,4搔鼻,5噴嚏,6咳嗽,7呼吸急促,8排尿,9排糞,10流淚,11呼吸困難,12哮鳴音,13紫癜,14步態(tài)不穩(wěn),15跳躍,16喘息,17痙攣,18旋轉(zhuǎn),19潮式呼吸,20死亡。 全身反應(yīng)評(píng)價(jià)標(biāo)準(zhǔn):過(guò)敏反應(yīng)陰性(-) 0分;弱陽(yáng)性(+) 1-4分;陽(yáng)性(++) 5-10分;強(qiáng)陽(yáng)性(+++) 11-19分;極強(qiáng)陽(yáng)性(++++) 20分 本次實(shí)驗(yàn)用90只小鼠進(jìn)行試驗(yàn),每次6只,每次分2組,每組3只,分對(duì)照組和試驗(yàn)組,小鼠自由分配。共進(jìn)行15次試驗(yàn)。 結(jié)果:試驗(yàn)組陽(yáng)性率較高,甚至有小鼠出現(xiàn)死亡的極強(qiáng)陽(yáng)性的表現(xiàn),而對(duì)照組陽(yáng)性率較低。 試驗(yàn)組陽(yáng)性例數(shù):7例躁動(dòng),3例呼吸急促,4例顫抖,4例排尿糞,6例步態(tài)不穩(wěn),5例旋轉(zhuǎn),2例噴嚏,2例死亡。試驗(yàn)組陰性例數(shù):12例。 對(duì)照組陽(yáng)性例數(shù):1例躁動(dòng),1例旋轉(zhuǎn),1例顫抖,2例呼吸困難。對(duì)照組陰性例數(shù):40例。 結(jié)論:藥疹病人血清注入小鼠背部局部皮下,24,48小時(shí)后再注入生理鹽水,這對(duì)照組45例中5例陽(yáng)性變化,病理無(wú)變化,而試驗(yàn)組為小鼠背部局部皮下注入藥疹患者血清,24,48小時(shí)后再注入藥疹患者致敏藥物,這試驗(yàn)組45例中有33例陽(yáng)性變化,病理有大量的炎細(xì)胞。通過(guò)試驗(yàn)組和對(duì)照組的比較,由于n40且所有T5(T為理論數(shù),n為例數(shù))用普通卡方檢驗(yàn)P0.01有統(tǒng)計(jì)學(xué)意義,說(shuō)明試驗(yàn)組和對(duì)照組出現(xiàn)差別,試驗(yàn)組陽(yáng)性率高于對(duì)照組。臨床上如果懷疑某患者對(duì)某藥過(guò)敏,可以通過(guò)藥疹患者血清注入小鼠背部局部皮下,24,48小時(shí)后再注入懷疑的致敏藥物,如果出現(xiàn)過(guò)敏反應(yīng)癥狀并且陽(yáng)性率較高,,病理出現(xiàn)大量炎細(xì)胞,則該患者可能對(duì)該藥過(guò)敏,可以停用該藥物。
[Abstract]:Objective: drug rash is called drug rash caused by drug injection, inhalation and so on. The adverse reactions caused by drugs are very complex, generally can be divided into drug overdoses, intolerance, side effects, secondary and anaphylaxis, and drug rash is the most common type of anaphylaxis. A variety of clinical applications are used in clinical practice. Drugs for the treatment of patients with drug allergy, when the patient can not stop drugs, can be tested by animal experiments to determine the patient's drug allergy, and then stop the drug, without stopping the use of other drugs, and not delay the patient's treatment. But the drug rash experiment is divided into skin tests and laboratory tests, both are imperfect. The experiment is to provide a reference for the detection of allergic drugs in patients with drug eruptions by injecting the serum of the patients with specific drug sensitization to the animal's part, through the systemic and local reactions after the injection. The animals used in this experiment are completed by the systemic and local reactions caused by the local injection of the mice. This experiment provides a reference for clinic to overcome the danger of traditional stimulation test.
Methods: this experiment was injected into the local subcutaneous of the back of the mice by the serum of the drug eruption patients, and the sensitized drugs were injected locally after 24,48 hours. The positive rate of the whole body reaction and the local reaction in the experimental group was higher, and the positive rate of the control group was low. 15 cases of drug eruptions were from the Department of dermatology at the Third Hospital of Hebei Medical University from March 2009 to December 2009. The drug rash patients were all inquired about the history of drug use and repeated the drug allergy. Of these, 5 were allergic and provocative tests from other departments. There were 2 cases of sparfloxacin allergy, 2 cases of levofloxacin allergy, 1 cases of two a double croak, 1 cases of penicillin allergy, 1 case of sulfanilamide allergy, and 8 cases of antipyretic and analgesic drug allergy. All of the mice were from the Hebei Medical University animal experiment center, the mice were randomly divided into subcutaneous injection in the back, and the control group was used drug rash. The patient's serum was injected into the subcutaneous part of the mouse's back, and the saline was injected locally after 24,48 hours. The local reaction and the whole body reaction were observed. The control group and the control group were compared with the experimental group. The experimental group and the control group were taken local tissue for general HE staining, and then the microscopic examination was performed. Finally, the local reaction and the whole body reaction were evaluated.
Allergic reaction symptoms: 0 normal, 1 restlessness, 2 erect hair, 3 tremors, 4 scratches, 5 sneezes, 6 coughs, 7 breaths, 8 urination, 9 dung, 10 tears, 11 breathing difficulties, 12 wheezing, 13 purpura, unstable gait, wheezing, spastic spasm, tidal breathing, death.
The general reaction evaluation criteria: allergic reaction negative (-) 0 points; weak positive (+) 1-4 points; positive (+ +) 5-10 points; strong positive (+ + +) 11-19 points; extremely strong (+ + + +) 20 points.
In this experiment, 90 mice were tested, 6 each time, each time was divided into 2 groups, each group 3, divided into the control group and the experimental group, the mice were allocated freely. Altogether 15 tests were carried out.
Results: the positive rate of the test group was higher, and even the death rate of the mice was very strong, while the positive rate of the control group was low.
The number of positive cases in the test group: 7 cases of restlessness, 3 cases of shortness of breath, 4 cases of trembling, 4 cases of urination, 6 cases of gait instability, 5 cases of rotation, 2 cases of sneezing, 2 cases of death. The number of negative cases in the test group: 12 cases.
Control group positive cases: 1 cases of restlessness, 1 cases of rotation, 1 cases of tremor, 2 cases of dyspnea. Control group negative cases: 40 cases.
Conclusion: the sera of the patients with drug eruption were injected into the subcutaneous part of the mouse's back, and then injected with saline after 24,48 hours. There were 5 positive changes in the 45 cases of the control group, and the pathological changes were not changed. The experimental group injected the serums of the local subcutaneous injection of drug eruptions in the mice back, and then the drug erupted after 24,48 hours, and there were 33 positive changes in the test group of 45 cases. There was a large number of inflammatory cells in the pathology. Through the comparison between the experimental group and the control group, the test group was significantly higher than the control group because of N40 and all T5 (T theory number, n as the number of cases) with ordinary chi square test, indicating the difference between the test group and the control group, and the positive rate of the test group was higher than that of the control group. When the serum is injected into the subcutaneous part of the mouse's back, the suspected sensitizing drug is injected after 24,48 hours. If the allergic reaction is found and the positive rate is high, a large number of inflammatory cells are found in the pathology, then the patient may be allergic to the drug, and the drug can be discontinued.
【學(xué)位授予單位】:河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2010
【分類號(hào)】:R758.25
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