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丙型肝炎病毒( HCV )感染是全球慢性肝病的主要病因之一,50%~80%的HCV感染者将进展为慢性状态,其中20%~30%的患者将发展为肝硬化或肝细胞癌( HCC)。据世界卫生组织报告,目前全球 HCV 感染人数超过1.85亿,每年死亡35万~50万例。近年来,我国丙型肝炎报告病例数及报告发病率快速上升,已成为严重的社会和公共卫生问题。 HCV基因有较强的变异性,变异位点可以发生在基因组的各个区域,其遗传变异性可分为6种基因型,每种基因型又可分为多种基因亚型。 HCV基因分型不仅有助于了解HCV演变及流行分布,也有助于了解丙型肝炎的危险因素以及肝脏疾病的进展情况。本研究旨在通过分析宁波地区HCV的基因型分布、感染状态和临床特征,为制订相应的防治策略提供参考。 相似文献
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新型隐球菌广泛分布在自然界中,可引起人类感染,大多经呼吸道吸入,在肺部引起轻度炎症,或隐性传染,亦可由破损皮肤及肠道传人.当机体免疫功能下降时可向全身播散,主要侵犯中枢神经系统.新型隐球菌感染的风险因素包括HIV感染、肝硬化、糖尿病、实体器官移植、恶性肿瘤、类风湿性疾病、皮质激素的使用和慢性肾脏疾病等¨].在未知或没有免疫抑制的人群中,也会发生隐球菌感染[2].在HIV感染高流行区,新型隐球菌性脑膜炎发病率高,且预后差.艾滋病患者并发隐球菌脑膜炎的病死率为9% ~ 55%,非HIV感染者病死率为15% ~44%[3].新型隐球菌脑膜炎的诊断和治疗对临床医师来说仍是一个挑战.本研究比较分析我院非HIV感染与HIV感染患者新型隐球菌脑膜炎的临床特点,为提高疾病的诊治水平积累经验. 相似文献
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Sangkhathat S Patrapinyokul S Wudhisuthimethawee P Chedphaopan J Mitamun W 《Journal of pediatric surgery》2003,38(11):1696-1698
Although infestation with Ascaris lumbricoides causes various intestinal complications, massive gastrointestinal bleeding is rare. The authors report on 2 infants who presented with massive hematemesis. In the first patient, a gastroduodenoscopy was performed. Roundworms were found adhering to an oozing duodenal ulcer. Duodenal perforation occurred after extraction of the parasites. The second case was hematemesis together with peritonitis. Exploration found volvulus and a gangrenous segment of the distal ileum. Both infants previously passed roundworms with their stool. The authors conclude that the intestinal ascariasis can be a cause of massive gastrointestinal bleeding, especially in temperate and tropical countries. 相似文献
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Y Dror Y Blachar P Cohen N Livni E Rosenmann A Ashkenazi 《American journal of kidney diseases》1998,32(5):825-828
Systemic lupus erythematosus (SLE) is a multisystem disease of unknown origin, characterized by a variety of autoimmune phenomena. Viruses have long been postulated to play a role in its pathogenesis. Several observations suggested a link between Epstein-Barr virus (EBV) and SLE. We describe a 14-year-old girl who presented with acute onset of SLE concurrently with clinical and laboratory findings consistent with EBV-induced infectious mononucleosis (IM). Evidence for acute EBV infection was confirmed by serological studies and detection of specific EBV antigens on kidney biopsy. This close association between EBV and SLE suggests a possible role of the virus in the pathogenesis of SLE in this patient. 相似文献
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Satoshi Ohta Hitoshi Yokoyama Kengo Furuichi Chikako Segawa Yukimasa Hisada Takashi Wada Kazuya Takasawa Ken-ichi Kobayashi 《Clinical and experimental nephrology》1997,1(3):216-224
Background We determined the incidence of hepatitis C virus (HCV)-related glomerulonephritis in Japan and the glomerular localization
of HCV-related antigens in this disorder.
Methods We analyzed urinalysis findings in 100 consecutive Japanese patients with HCV chronic liver disease from 1993 to 1994. Immunohistochemical
analysis using monoclonal or polyclonal antibodies to HCV-core antigen and polyclonal antibodies to HCV-envelope antigen was
done on kidney specimens from 11 of 29 patients with antibody to HCV (anti-HCV-Ab).
Results Eight of 100 patients had proteinuria, but only 2 cases (2%) were related to HCV nephropathy. Pathohistologic analysis showed
10 patients to have hepatic glomerulosclerosis, and 9 patients had mesangial proliferative glomerulonephritis involving primary
immunoglobulin A nephropathy. Membranoproliferative glomerulonephritis was seen in 4 biopsy specimens that showed subendothelial
electron-dense deposits and annular structures with characteristic cryogloblin. HCV core antigen was detected along the capillary
walls with the same pattern as that of immunoglobulin G deposition and electron-dense deposits in 5 of 6 specimens from patients
with both anti-HCV-Ab and HCV ribonucleic acid positive in the sera, but could not be detected in any of 3 specimens, from
patients with anti-HCV-Ab but no HCV ribonucleic acid. Envelope antigen was not detected in the glomeruli of any specimens.
Conclusions Glomerular lesions associated with HCV infection were characterized by deposition of immune complexes containing HCV core
antigen and immunoglobulin G, and by the subendothelial deposition of cryoglobulin. These HCV-related glomerular diseases
are rare in Japan (2% incidence), and these lesions should be distinguished from hepatic glomerulosclerosis related to advanced
liver disease and other primary glomerular diseases. 相似文献
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Hepatitis C virus infection and acute or chronic glomerulonephritis: an epidemiological and clinical appraisal 总被引:1,自引:0,他引:1
Fabrizi F; Pozzi C; Farina M; Dattolo P; Lunghi G; Badalamenti S; Pagano A; Locatelli F 《Nephrology, dialysis, transplantation》1998,13(8):1991-1997
Background. The relationship between hepatitis C virus
(HCV) infection and acute or chronic glomerulonephritis (GN) is not well
understood. Methods. Two hundred and eighty-four
patients with biopsy-proven GN and other renal diseases were studied in a
multicentre survey performed during the period 1992-1995. Several clinical
parameters were collected for each patient at the time of renal biopsy. We
made a multivariate analysis by logistic regression model to evaluate the
independent association of clinical and histological patient
characteristics with HCV infection, as detected by anti-HCV antibody
testing. In addition, three patients with HCV-related liver disease;
membranous nephropathy, and proteinuria in the nephrotic range received
therapy with interferon-alpha in standard doses.
Results. The prevalence of anti-HCV positivity was 13%
(38/284). The frequency of anti-HCV positivity ranged between 0 and 100% in
the different types of renal diseases, the difference was statistically
significant (P = 0.0001). The anti-HCV rate was
significantly higher in patients with cryoglobulinaemic
membrano-proliferative and mesangioproliferative GN than among the other
individuals (14/14 (100%) vs 24/270 (9%),
P = 0.0002). Our multivariate analysis by logistic
regression model showed that age (P = 0.0017) and type
of renal diseases (P = 0.0007) were independently and
significantly associated with anti-HCV antibody. At the completion of
treatment with interferon-alpha, 67% (2/3) of patients with membranous
nephropathy had lowering of hepatic enzyme levels into the normal range
whereas 100% (3/3) of these did not show significant reduction of
proteinuria. Conclusions. We observed strong
association between HCV infection and cryoglobulinaemic GN. Age and type of
renal disease were important independent predictors of anti-HCV positivity
in our cohort of patients. Three anti-HCV-positive patients with membranous
nephropathy did not show significant remission of nephrotic proteinuria
after treatment with interferon-alpha. Our data do not appear to support an
association between HCV and non-cryoglobulinaemic GN. Further
epidemiological surveys, experimental studies and clinical trials are
warranted to fully elucidate the role of HCV in non-cryoglobulinaemic GN. 相似文献
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Respiratory syncytial virus infection in children hospitalised with acute lower respiratory tract infection. 总被引:1,自引:0,他引:1
G D Hussey P Apolles Z Arendse J Yeates A Robertson G Swingler H J Zar 《Suid-Afrikaanse tydskrif vir geneeskunde》2000,90(5):509-512
BACKGROUND: Data are lacking on respiratory syncytial virus. (RSV) respiratory tract infections in children from developing countries. OBJECTIVE: To determine the importance of RSV as a cause of acute lower respiratory tract infection (ALRTI) in Cape Town children. METHODS: Children younger than 2 years of age admitted to hospital with ALRTI over a 15-month period from 1 June 1995 to 31 August 1996 were studied prospectively. Sociodemographic data, risk factors for severe RSV disease, clinical signs, diagnosis and hospital course were documented. A nasopharyngeal aspirate (NPA) for detection of RSV by enzyme immunoassay (EIA) was obtained in all cases. The NPA of every fifth child was sent for viral culture. RESULTS: A total of 1,288 patients (60% male, 40% female) with a median age (25th-75th percentile) of 6 months (2-11 months) was enrolled; 32.4 had one or more risk factors for severe RSV infection. Pneumonia was diagnosed in 62.2%, bronchiolitis in 20.6%, laryngotracheobronchitis (LTB) in 8% and other respiratory illnesses in 9.2%. Mild disease, requiring admission to an overnight ward, was documented in 38.1%, while 48.9% and 13% respectively had moderate and severe disease requiring admission to a general ward and intensive care unit (ICU). Supplemental oxygen and mechanical ventilation were required by 68.9% and 8.5% of patients, respectively. The median duration of hospital stay was 5 days (range 1-10 days). RSV EIA was positive in 16.4% of cases, and there was no difference in detection rates according to diagnosis. Viral culture performed in 162 of the 1,288 study patients (12.6%) grew RSV in 11.7% of cases, adenovirus in 3.7%, para-influenza virus type 3 in 2.5% and influenza B virus in 0.6%. Patients who tested RSV EIA-positive did not significantly differ from those who tested negative with regard to demographic variables, clinical diagnoses, risk factors for RSV or length of hospitalisation. The only significant difference noted was the presence of hyperinflation, which occurred in 70.1% of EIA-positive patients compared with 57.1% of those testing negative (P = 0.0005). The mortality rate (2%) was similar for both groups. CONCLUSION: This study indicates that RSV is an important cause of hospitalisation in infants and young children with ALRTI. Distinguishing RSV from other ALRTIs is difficult because of similarity in clinical presentation among children. 相似文献