Sun Qin, Sha Wei, Gui Xu-Wei, Xiao Yang-Jiong, Zeng Wei-Hong, Sun Wen-Wen, Xiao He-Ping, Ye Wei-Yi
Clinic and Research Center of Tuberculosis, Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.
Clinic and Research Center of Tuberculosis, Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.
Diagn Microbiol Infect Dis. 2015 Jun;82(2):172-6. doi: 10.1016/j.diagmicrobio.2015.03.008. Epub 2015 Mar 13.
Antituberculosis (TB) chemotherapeutic drugs may cause a variety of adverse drug reactions (ADRs). To assess the potential of drug-induced lymphocyte stimulation test (DLST) in screening ADRs in patients treated with anti-TB drugs, we performed DLST in 272 TB patients (176 cases with ADRs and 96 controls without ADRs) treated with anti-TB drugs isoniazid (INH), rifampicin (RFP), ethambutol (EMB), and pyrazinamide (PZA). The ADRs were diagnosed by drug provocation test based on clinical and laboratory examinations. The sensitivities of DLST in the diagnosis of INH-, RFP-, EMB-, or PZA-induced ADRs were 57.8%, 37.1%, 42.4%, and 23.1%, respectively, with the corresponding specificities being 93.4%, 94.0%, 97.5%, and 98.8%. DLST has high specificity and limited sensitivity in the diagnosis of anti-TB drug-induced ADRs. In combination with clinical observation and drug use history, DLST could have a predictive validity of ADRs, especially when a positive result is obtained.
抗结核化疗药物可能会引起多种药物不良反应（ADR）。为评估药物诱导淋巴细胞刺激试验（DLST）在筛查接受抗结核药物治疗患者的ADR方面的潜力，我们对272例接受异烟肼（INH）、利福平（RFP）、乙胺丁醇（EMB）和吡嗪酰胺（PZA）抗结核药物治疗的结核病患者（176例有ADR，96例无ADR的对照）进行了DLST。ADR通过基于临床和实验室检查的药物激发试验进行诊断。DLST诊断INH、RFP、EMB或PZA诱导的ADR 的敏感性分别为57.8%、37.1%、42.4%和23.1%，相应的特异性分别为93.4%、94.0%、97.5%和98.8%。DLST在诊断抗结核药物诱导的ADR方面具有高特异性和有限的敏感性。结合临床观察和用药史，DLST对ADR可能具有预测效度，尤其是当获得阳性结果时。
