利巴韦林气雾剂治疗儿童病毒性上呼吸道感染82例

目的 观察利巴韦林气雾剂治疗儿童病毒性上呼吸道感染的疗效。方法 随机将160例病毒性上呼吸道感染患儿分为两组，治疗组82例采用利巴韦林气雾剂加常规治疗，对照组78例常规治疗，观察其疗效及对血常规的影响。结果 治疗组3d总有效率为90．24％，对照组总有效率43．59％，差异显著（P〈0．01）且对血常规无明显影响。结论 儿童病毒性上呼吸道感染早期用利巴韦林气雾剂加常规治疗，疗效确切，值得推广。     

Ribavirin treatment of respiratory syncytial viral infection in infants with underlying cardiopulmonary disease

Aerosolized ribavirin was evaluated in the treatment of respiratory syncytial virus lower respiratory tract disease in 53 infants, 36 of whom had underlying diseases. Of the total infants, 26 were studied in a double-blind, placebo-controlled manner; 14 received ribavirin and 12 received placebo, a water aerosol, for an average of five days. When the infants with bronchopulmonary dysplasia and congenital heart disease treated with ribavirin were compared with those receiving placebo, the treated infants showed a significantly faster rate of improvement in their illness severity score. The degree of improvement in the total group of infants receiving ribavirin compared with those receiving placebo was similarly greater, and at the end of therapy significantly greater improvement was also demonstrated in their arterial blood gas values and in the amount of virus shed from their nasal washes. No toxic or adverse effects of the aerosol therapy were observed in any of the 53 infants studied, and resistance to ribavirin did not develop in any of the respiratory syncytial virus strains isolated, despite prolonged treatment in some of the more ill infants.     

特异性反义寡核苷酸抗小鼠呼吸道合胞病毒感染的研究

目的 比较研究特异性抑制呼吸道合胞病毒(respiratory syncytial virus,RSV)的反义核苷酸(antisense oligodeoxynucleotide,AS-ODN)和利巴韦林对RSV感染小鼠的治疗作用,寻求安全有效的抗RSV药物.方法 特异性ASODN和利巴韦林滴鼻治疗RSV感染BALB/c鼠,空斑形成实验检测肺组织病毒滴度,RT-PCR和免疫组织化学分析RSVmRNA和蛋白表达水平,支气管肺泡灌洗液(BALF)白细胞计数、肺组织病理学检查了解气道炎症和治疗副作用.结果 0.2、0.4 mg AS-ODN和0.8 mg利巴韦林能降低RSV感染小鼠肺组织病毒滴度,空斑抑制率分别为34.48%、46.75%和23.02%,与感染对照组比较差异显著(P＜0.05).0.4 mg AS-ODN抑制RSV mRNA和蛋白表达,抑制率分别为30.54%和29.41%,0.4 mg利巴韦林治疗降低17.65%的RSV蛋白表达.AS-ODN和利巴韦林都降低RSV感染小鼠BALF中白细胞总数,对肺组织病理性改变没有明显改善作用,与感染对照组比较差异不显著(P＞0.05).单独AS-ODN和利巴韦林滴鼻不会引发明显肺炎症病理损害.结论 AS-ODN在小鼠体内有比利巴韦林更强的抗RSV作用,经滴鼻治疗没有明显毒副作用,是安全而有效的抗RSV制剂.     

Refractory congestive heart failure after ribavirin in infants with heart disease and respiratory syncytial virus

Although treatment with ribavirin has been known to be associated with a decreased mortality in infants with congenital heart disease (CHD) who have respiratory syncytial virus (RSV), few data are available regarding morbidity. We reviewed records of 10 consecutively hospitalized infants with CHD during a recent RSV epidemic. Despite the presence of left-to-right shunt in each patient, symptoms of RSV were respiratory at presentation. After ribavirin, decreased respiratory symptoms were found in 8 infants but in 2 assisted ventilation were required 1 and 3 days after admission. Congestive heart failure worsened in 8 patients, 6 of whom had improved respiratory status after ribavirin. Of the 8 patients with worse CHF (pulmonary edema), 3 responded to medical management but 5 were refractory and 4 required surgical repair of CHD. One patient died of pulmonary hemorrhage. Medically refractory CHF may develop in infants with CHD who become infected with RSV and are treated with ribavirin. Further studies are needed to determine whether the pulmonary edema is caused by RSV, ribavirin, or combination of effects on pulmonary capillary function or some other unrecognized mechanism.     

利巴韦林气雾剂治疗小儿疱疹性咽峡炎临床观察

目的临床观察利巴韦林气雾剂治疗小儿疱疹性咽峡炎的疗效。方法共80例临床诊断为疱疹性咽峡炎的患儿,随机分为治疗组和对照组,每组40例,两组病例治疗前性别、年龄、病程及临床症状等无统计学差异。治疗组喷利巴韦林气雾剂,对照组口服双黄连口服液,均连用5d。结果两组用药后,在退热、咽痛、溃疡愈合等方面比较有统计学差异。结论利巴韦林气雾剂治疗小儿疱疹性咽峡炎疗效确切,起效迅速,无毒副作用,可作为治疗疱疹性咽峡炎的首选药。     

大剂量病毒唑治疗流行性出血热对肝脏影响的研究

采用双盲法,大剂量病毒唑(345mg/kg)治疗 EHF 的同时,观察了用药组126例与安慰剂组118例,各病期肝脏功能损害情况,血清 GPT 及 GOT活性升高,总蛋白及白蛋白含量明显下降,两组间差异无显著性(P>0.05)。说明 EHF 患者肝实质细胞的损害较普通,应用病毒唑后,不会加重肝脏的损害。     

Ribavirin aerosol treatment of influenza B virus infection

In a randomized, controlled study, ribavirin small-particle aerosol was found to be effective in the treatment of influenza B virus infection in a group of college students. Eleven treated patients experienced significantly more rapid defervescence, disappearance of systemic illness, and reduction of virus shedding in nasal secretions than ten control patients treated with a saline aerosol. Antibody response to infection was similar in both groups. The treatment was well tolerated, and hematologic and clinical chemical tests demonstrated no toxicity. The estimated dose of ribavirin aerosol retained was about 2 g in 39 hours of treatment during the first 60 hours in the hospital.     

小儿豉翘清热颗粒联合利巴韦林气雾剂治疗儿童急性上呼吸道感染的效果

目的探讨小儿豉翘清热颗粒联合利巴韦林气雾剂治疗儿童急性上呼吸道感染(URI)疗效。方法选择2016年9月~2017年9月浙江省台州市肿瘤医院,温岭市第二人民医院儿科门诊URI患儿100例,按就诊次序分为对照组和观察组,对照组50例予利巴韦林气雾剂,疗程5 d;观察组50例在对照组基础上予小儿豉翘清热颗粒口服,疗程5 d,5 d后评价疗效。结果观察组的有效率为98.0%,对照组有效率为84.0%,两组比较差异有显著性(P0.01);观察组的体温消退时间、鼻塞消失时间、流涕消失时间、咳嗽消失时间均短于对照组(P0.05)。结论小儿豉翘清热颗粒联合利巴韦林气雾剂可显著改善儿童URI症状。     

雪貂感染H7N9禽流感病毒动物模型的建立

目的建立雪貂感染H7N9禽流感病毒动物模型。方法A／Anhui／1／2013（H7N9）禽流感病毒经鼻吸入感染雪貂,观察动物临床症状和体征,上呼吸道排毒情况及组织病理学变化。结果雪貂感染后出现体重下降、活动减少以及打喷嚏的临床表现,上呼吸道、心脏、肝脏及嗅球可检测到活病毒,上呼吸道排毒的峰值出现在感染后的第3—5天。血清抗体滴度最高达到1280,外周血淋巴细胞数量减少、粒细胞数量增加。组织病理学显示动物肺脏呈局灶性间质性肺炎及肺泡炎改变,CT显示肺内片状阴影。结论成功建立雪貂感染H7N9禽流感病毒的动物模型,模型的建立为H7N9禽流感发病机制研究、药物及疫苗的评价奠定了实验基础。     

ClinicalandExperimentalStudyonTreatmentofAcuteRespiratoryTractInfectionwithShuanghuanglianAerosol（双黄连气雾剂）

ＣｌｉｎｉｃａｌａｎｄＥｘｐｅｒｉｍｅｎｔａｌＳｔｕｄｙｏｎＴｒｅａｔｍｅｎｔｏｆＡｃｕｔｅＲｅｓｐｉｒａｔｏｒｙＴｒａｃｔＩｎｆｅｃｔｉｏｎｗｉｔｈＳｈｕａｎｇｈｕａｎｇｌｉａｎＡｅｒｏｓｏｌ（双黄连气雾剂）ＣｌｉｎｉｃａｌａｎｄＥｘｐｅｒｉｍｅｎ...     

中成药辨证治疗小儿合胞病毒急性上感临床研究

目的：对小儿急性上呼吸道感染合胞病毒感染状况及中成药辨证方案治疗进行研究。方法：收集2009年4月—2011年1月济南、沈阳、南京地区急性上呼吸道感染患儿,辨证分型后随机分成两组,对照组使用利巴韦林抗病毒常规治疗,治疗组应用上市中成药辨证治疗方案治疗,3 d 1个疗程,检测合胞病毒并观察上市中成药辨证治疗效果及相关因素。结果：收集1090例病例,合胞病毒感染率为12.56%,学龄前儿童易感,秋季感染居多,南京和济南较沈阳合胞病毒感染率高,合胞病毒阳性者表寒里热证多见。结论：合胞病毒感染为小儿急性上感的常见病毒,其感染率与季节、地域、年龄相关,与中医辨证有相关性,中成药辨证治疗优势显著。     

麻黄加术汤对寒湿环境下小鼠脾淋巴细胞增殖能力作用的实验研究

目的探讨寒湿环境因素对正常及呼吸道合胞病毒感染小鼠脾淋巴细胞增殖能力的影响以及麻黄加术汤的治疗作用。方法借助人工气候箱模拟寒湿外邪环境,通过体外细胞培养、MTT法检测脾淋巴细胞增殖能力的变化,分析寒湿外邪及麻黄加术汤对病毒感染小鼠免疫状态产生的影响。结果与正常组比较,病毒组和寒湿组均使小鼠脾淋巴细胞增殖能力显著下降（P〈0．001）。与病毒模型组和寒湿病毒模型组分别比较,麻黄加术汤和利巴韦林均使小鼠脾淋巴细胞的增殖能力显著升高（P〈0．001）;与病毒＋麻黄加术汤组比较,寒湿病毒＋麻黄加术汤组显著降低（P〈0．05）。结论寒湿环境对上呼吸道感染小鼠脾淋巴细胞增殖能力的影响较呼吸道合胞病毒滴鼻更加显著。麻黄加术汤可提高小鼠的免疫功能,而其对寒湿病毒所致小鼠脾淋巴细胞的增殖能力降低的改善不及病毒所致,可能是由于寒湿病毒较病毒使小鼠脾淋巴细胞的增殖能力降低更显著所致。     

Clinical and experimental study on treatment of acute respiratory tract infection with Shuanghuanglian Aerosol

Two hundred and two cases of acute respiratory tract infection (ARI) were treated with Shuanghuanglian (SHL) aerosol. In these cases, the majority were virus infection and 64% of them was caused by the respiratory syncytial virus (RSV). The virostatic and bacteriostatic test were done in vitro by the cell culture method and it was shown that SHL could inhibit the RSV, para-influenza virus I ~ IV and 23 kinds of pathogenic bacteria such as Staphylococcus aureus etc. The bacteriostatic effect was positively correlated to the SHL concentration. Experimental study showed that SHL could enhance the NK cell activity, promote the production of α-interferon and raise the rate of lymphocyte transformation. The controlled observation on SHL preparation with various dosage-forms revealed that the SHL aerosol in treating early ARI showed better results than that of injections and oral liquid symptomatologically (P<0.05). The total effective rate was 96%.     

馥感啉口服液对呼吸道合胞病毒感染小鼠的治疗作用

目的: 研究馥感啉口服液对呼吸道合胞病毒(respiratory syncytial virus, RSV)感染小鼠的治疗作用。方法: 将120只ICR小鼠随机分为对照组,模型组,利巴韦林组,馥感啉5、10和20 g/kg组。采用滴鼻感染法感染RSV后,根据实验分组分别进行灌胃给药治疗,对照组及模型组用等量的生理盐水进行治疗处理,每日2次,共6 d。通过HE染色分析馥感啉口服液对小鼠肺病变的治疗情况,分别采用ELISA和RT PCR方法检测小鼠肺泡灌洗液及肺组织中IFN β、IL 6的含量及mRNA表达水平。流式细胞术检测小鼠外周血CD3+CD4+,CD3+CD8+水平。结果： 成功建立RSV感染小鼠模型。HE病理结果显示不同治疗方法对肺组织病变均有不同情况改善,其中以馥感啉10 g/kg组和20 g/kg组对小鼠肺组织病变改善作用最为明显。馥感啉口服液各剂量组小鼠IFN β和IL 6含量及mRNA表达水平随用药时间延长而逐渐降低;与对照组相比,模型组、利巴韦林组及馥感啉5 g/kg组CD3+CD4+水平显著升高(P均<0.05),馥感啉10 g/kg组和20 g/kg组CD3+CD4+显著降低(P均<0.05);与对照组相比,模型组CD3+CD4+/CD3+CD8+水平显著升高(P<0.05),馥感啉20 g/kg组显著降低(P<0.05),利巴韦林组、馥感啉5 g/kg组及10 g/kg组CD3+CD4+/CD3+CD8+水平与对照组相比,差异均无统计学意义(P>0.05)。结论： 馥感啉口服液各剂量组对小鼠RSV感染有一定的治疗效果,并在一定范围内存在剂量效应关系,高剂量组治疗效果更加显著。     

呼吸道合胞病毒对支气管哮喘的诱发作用

目的:探讨RSV与哮喘发病的可能关系。方法:应用间接酶联免疫吸附试验(ELISA)对44例哮喘患者的血清进行RSV特异性IgG抗体检测。结果:44例哮喘患者,RSV感染20例,占45％,其中发热5/13例为RSV感染,哮喘反复发作2/9例为RSV感染,1例半年内发作2次,两次住院均为RSV感染,另1例1年之内发作3次,两次为RSV感染。春夏季节发病RSV阳性4/17例,秋冬季节发病RSV阳性16/27例(x~2=5.34,P<0.05)。结论:哮喘的发作或加重与RSV感染密切相关,其发病机制与病毒感染损伤呼吸道粘膜、机体免疫功能低下有关。     

金欣口服液对感染RSV大鼠血清IL12表达水平的影响

目的?观察金欣口服液对感染呼吸道合胞病毒（RSV）大鼠血清IL12表达水平的影响,以寻找更有效的抗RSV感染方式。方法?将96只SD大鼠随机分为12组,分别为空白对照组,模型组,金欣高、中、低灌胃组,金欣高、中、低灌肠组,利巴韦林灌肠、灌胃组,金欣预先灌胃、灌肠组。用双抗体夹心酶联免疫吸附法(ELISA)测定各组SD大鼠血清IL12的水平。结果? 与空白对照组比较,模型组感染RSV后血清IL12水平明显下降(P<0.01）;金欣组的高剂量灌胃组、中剂量灌胃组、中剂量灌肠组及预先灌胃组的IL12水平较模型组显著升高(P<0.01）,且与利巴韦林组有明显差异(P<0.01）。灌胃组中预先给药的IL12含量比其他给药组相比显著增加(P<0.01）。与灌肠给药相比,灌胃给药的预先组和金欣高剂量组的IL12较高(P<0.01）。 结论?金欣口服液能提高血清IL12的表达,且以灌胃方式提前给药能够更有效地抑制大鼠感染RSV。      

白藜芦醇对呼吸道合胞病毒感染小鼠肺部病毒滴度及其气道炎症的影响

目的 研究白藜芦醇(resveratrol,RES)对呼吸道合胞病毒（respiratory syncytial virus,RSV）感染小鼠肺部病毒滴度及其所致气道炎症的影响。方法6～8周龄雌性BALB/c小鼠,环磷酰胺100 mg/kg腹腔注射后,随机分为对照组、RSV感染组、白藜芦醇腹腔注射组、白藜芦醇雾化组,每...     

急性呼吸道感染住院患儿鼻咽部病毒检测分析

目的： 调查盐城地区急性呼吸道感染（ARI）住院患儿的病毒病原学情况,为本地区儿童ARI防治提供依据。方法: 收集2011年6月至2012年7月ARI患儿的鼻咽分泌物标本1 582份,采用直接免疫荧光法检测呼吸道合胞病毒（RSV）、流感病毒A（IVA）、流感病毒B（IVB）、副流感病毒1-3（PIV 1-3）以及腺病毒7种病毒。结果: 1 582例标本中有426例检出病毒（26.9%）,其中RSV检出率最高,为289例（18.3%）,其次是腺病毒,为46例（2.9%);病毒的总检出率在年龄及季节分布上有统计学差异,以6个月～1岁年龄组检出率最高,冬春季发病率较高。结论: RSV及腺病毒是盐城地区ARI住院患儿病毒感染的主要病原体,其检出率与年龄及季节分布有明显相关性。     

呼吸道合胞病毒感染患儿血清嗜酸性粒细胞趋化蛋白测定的临床意义

目的探讨呼吸道合胞病毒(RSV)感染患儿血清嗜酸性粒细胞趋化蛋白(eotaxin)的表达与呼吸道高气道反应的相关性。方法收集40例RSV感染患儿的血清,其中27例为哮喘急性发作患儿(哮喘组),13例为喘息性支气管炎(喘支组),采用双抗体夹心酶联免疫吸附试验(ELISA)方法测其血清eotaxin的含量,并与正常对照组比较。结果哮喘组与喘支组及正常对照组的eotaxin含量比较均有显著性意义(P<0.05)。血清eotaxin的水平与外周血嗜酸性粒细胞(Eos)总数呈正相关(r=0.4196,P<0.001)。结论RSV感染后血清趋化因子表达增加,导致气道高反应是RSV感染致哮喘的病理基础。