柴胡注射液和病毒唑联用对呼吸道合胞病毒的抑制作用

长期以来 ,临床上单用病毒唑进行呼吸道合胞病毒 (RSV)的病因治疗取得了一定效果 ,为了进一步提高抗 RSV的疗效 ,降低毒性 ,减少耐药 ,我们把柴胡注射液和病毒唑联用对 RSV的抑制作用 ,与单用病毒唑对 RSV的抑制作用比较如下。1　材料和方法1 .1　材料　柴胡注射液由河南淅川制药厂生产 ,批号为0 1 0 81 4。病毒唑注射液由武汉第二制药厂生产 ,批号 :0 1 0 52 6。RSV为 Long株 ,培养细胞为 Vero细胞 ,两者均由武汉协和医院病毒研究室提供。1 .2　方法1 .2 .1　药物毒性试验　 Vero细胞长成单层后 ,将柴胡注射液稀释成 2 0 mg/ ml,1 …     

咳喘平与病毒唑联合应用体外对呼吸道合胞病毒抑制作用的研究

目的了解咳喘平、病毒唑及二者联合应用时对呼吸道合胞病毒(RSV)的体外抑制作用。方法观察不同药物浓度下RSV对Hep-2细胞的致病作用。结果病毒唑完全抑制RSV复制的最小浓度为7·8μg/ml,咳喘平为13·75mg/ml,两药联合应用时,病毒唑和咳喘平完全抑制RSV的最小浓度分别减少到1·95μg/ml和3·44mg/ml,比单独用药浓度降低了4倍。结论两种药物对RSV都有体外抑制作用,联合应用时效果最强。     

病毒唑雾化吸入治疗呼吸道合胞病毒肺炎的护理

呼吸道合胞病毒（RSV）是婴幼儿下呼吸道感染的主要病原体，RSV感染通常引起婴幼儿严重的毛细支气管炎和肺炎，RSV感染的治疗目前无理想的抗病毒药物。1996年12月-1997年3月，我们对病原学证实为RSV感染的40例肺炎患儿采用超声雾化治疗，取得了较好效果，现将我们治疗护理体会报告如下。1临床资料1．1病原学检测：所有病例均为住院患儿，肺炎诊断符合1987年卫生部小儿肺炎防治方案标准，病原学采用APAAP法测鼻咽分泌物（NPS）中RSV抗原和检测血清RSV－IgM［1］两者同时阳性为所选病例。1．2雾化吸入组和对照组：将40例RSV肺炎…     

黄芩苷抗呼吸道合胞病毒感染作用的体外研究

目的探讨黄芩苷（baicalin）的体外抗呼吸道合胞病毒（RSV）感染作用及最佳浓度。方法应用微量细胞培养技术，观察RSV感染人喉癌（Hep-2）细胞病变效应（CPE）。观察不同浓度黄芩苷对人肺癌腺上皮（A549）细胞的CPE及RSV感染后CPE的抑制作用。应用四甲基偶氮唑蓝（MTT）比色法检测黄芩苷对A549细胞的毒性作用和RSV感染后细胞存活率的影响。结果黄芩苷浓度≤0．156mg／ml时，A549细胞未显示明显CPE，MTT比色法结果与CPE观察结果相符；浓度在0．078～1．25mg／ml时，RSV感染的A549细胞仅出现轻微CPE，0．625mg／ml时对CPE有最好的保护作用；治疗指数（Ⅱ）为19．23；MTT比色法也显示以上浓度范围黄芩苷组的细胞存活率明显高于RSV感染组，差异有统计学意义（P均〈0．05），其中以0．3125mg/ml组的细胞存活率最高，达82．09％。结论黄芩苷具有体外抗RSV感染作用，有效浓度为0．078～1．25mg／ml，最佳作用浓度为0．156mg／ml。     

新生儿RSV下呼吸道感染的临床特征

目的探讨新生儿呼吸道合胞病毒下呼吸道感染的临床特征。方法对2013年2月至2014年2月期间NICU收治的新生儿肺炎及毛细支气管炎患儿,用直接免疫荧光法检测痰液呼吸道合胞病毒(RSV);对证实为RSV感染的临床资料进行回顾性总结分析。全部病儿除具有呼吸道症状外,肺部听诊可闻中小水泡音和/或胸片有斑片状阴影。结果检测证实为RSV感染者共30例,男性为多,22例(73.3%)。发病日龄为9~28 d,全部为晚期新生儿。出生时孕周35~42周(39.33±1.45周),2例为早产儿。患儿均有咳嗽症状,19例肺部听诊有中小水泡音,出现发热或喘鸣音者各有5例(16.7%);发生呼吸衰竭3例(10.0%)。血常规及CRP检测大部分正常。痰培养细菌阳性14例(43.3%)。胸片表现为斑片状阴影20例(66.7%),其中有大片影2例(6.7%);肺纹理粗重、模糊10例。经综合治疗全部病人均痊愈或好转出院。肺部啰音消失的平均病程为11.10±2.20 d;平均住院时间8.53±2.35 d。结论新生儿RSV下呼吸道感染的临床表现不典型,以咳嗽、鼻塞、气促及肺部中小水泡音多见,喘鸣音少见。抗生素应用的益处尚需评估。     

急性呼吸道感染患儿MP、RSV和ADV血清流行病学调查

目的探讨济宁地区2000～2005年6年间急性呼吸道感染(ARI)患儿肺炎支原体(MP)、呼吸道合胞病毒(RSV)、腺病毒(ADV)的感染情况。方法用ELISA方法检测患儿血清中特异性IgM抗体。结果患儿血清标本MP、RSV和ADV的阳性率分别是31.37%、40.64%、22.03%;RSV和ADV在婴儿及学龄前儿章患儿中的阳性率显著高于学龄期儿童,MP在学龄期儿童感染率较高;MP和RSV感染率男女差异显著(P<0.005)。结论济宁地区儿童ARI人群中MP、RSV和ADV的感染率较高,临床上应重视ARI的病原学研究,检测早期出现的特异性IgM抗体,对临床诊断有重要价值。     

海岛地区婴幼儿呼吸道感染的病原学研究

目的 探讨海岛地区婴幼儿急性呼吸道感染的病毒病原.方法 采取211例急性呼吸道感染患儿的痰液做病毒检测.结果 病毒感染35例,其中呼吸道合胞病毒(RSV)感染20例(9.5%),流感病毒感染6例(2.8%),腺病毒9例(4-3%),副流感病毒Ⅲ型4例(1.9%),副流感病毒Ⅰ、Ⅱ型各2例(1%).结论 RSV感染仍是海岛婴幼儿急性呼吸道病毒感染最常见的病原,病毒病原的诊断可为临床诊断和治疗提供可靠的依据.     

蛭丹化瘀中药配方颗粒冲剂与饮片煎剂体外抗RSV作用比较

目的　了解蛭丹化瘀中药配方颗粒冲剂与饮片煎成的蛭丹化瘀口服液在体外抑制呼吸道合胞病毒(RSV)作用是否相同。方法　观察RSV在两种制剂、不同药物浓度下对HEp -2细胞的致病作用。结果　蛭丹化瘀中药配方颗粒冲剂完全抑制RSV复制的最小浓度为 2 75mg/ml ;中药饮片煎成的蛭丹化瘀口服液完全抑制RSV复制的最小浓度为 2 75mg/ml。结论　两种制剂在体外抑制RSV复制作用强度相同 ,中药配方颗粒在加工过程中未改变药物的药性。     

高密度脂蛋白的体外抑制病毒作用研究

高密度脂蛋白的体外抑制病毒作用研究１３００６１吉林省血液中心杨宝田门小菲任海波赵晏丰金成日王倩张兴义白求恩医科大学李凡邓继业病毒是传染病中一类主要病原，虽然目前疫苗接种已成为控制病毒性传染病的一种手段，但并未使其得到完全控制。近年来发现，高密度脂蛋白...     

RSV毛细支气管炎RANTES MIP-1α IL-8水平变化及相关性研究

目的探讨呼吸道合胞病毒（RSV）毛细支气管炎（简称RSV毛支）RANTES、MIP-1α、IL-8的动态变化及相关性。方法RSV毛支组26例为住院的RSV毛细支气管炎患儿，年龄1．5-11．0个月；对照组为14例择期手术患儿，年龄5．4～15．1个月。应用ELISA法分别检测RSV毛支组急性期和恢复期鼻咽分泌物RANTES、MIP-1α、IL-8浓度。结果对照组鼻咽分泌物未测到RANTES和MIP-1α，测得低水平的IL-8；RSV毛细支气管炎患儿急性期RANTES、MIP-1α、IL-8明显高于对照组；恢复期RANTES、IL-8下降，但仍高于对照组；MIP-1α恢复期和急性期差异无显著性（P〉0．05），但高于对照组（P〈0．001）。RANTES与MIP-1α、IL-8及MIP-1α与IL-8间有正相关关系。结论RSV毛细支气管炎患儿RANTES、MIP-1α、IL-8明显升高，提示趋化因子可能在RSV感染的气道炎症中起重要作用。     

High frequency oscillatory ventilation for respiratory failure due to RSV bronchiolitis

OBJECTIVE: To describe the time course of high frequency oscillatory ventilation (HFOV) in respiratory syncytial virus (RSV) bronchiolitis. DESIGN: Retrospective charts review. SETTING: A tertiary paediatric intensive care unit. PATIENTS AND PARTICIPANTS: Infants with respiratory failure due to RSV infection. INTERVENTION: HFOV. MEASUREMENTS AND RESULTS: Pattern of lung disease, ventilatory settings, blood gases, infant's vital parameters, sedation and analgesia during the periods of conventional mechanical ventilation (CMV, 6 infants), after initiation of HFOV (HFOVi, 9 infants), in the middle of its course (HFOVm), at the end (HFOVe) and after extubation (Post-Extub) were compared. All infants showed a predominant overexpanded lung pattern. Mean airway pressure was raised from a mean (SD) 12.5 (2.0) during CMV to 18.9 (2.7) cmH(2)O during HFOVi (P < 0.05), then decreased to 11.1(1.3) at HFOVe (P < 0.05). Mean FiO(2) was reduced from 0.68 (0.18) (CMV) to 0.59 (0.14) (HFOVi) then to 0.29 (0.06) (P < 0.05) at HFOVe and mean peak to peak pressure from 44.9 (12.4) cmH(2)O (HFOVi) to 21.1 (7.7) P < 0.05 (HFOVe) while mean (SD) PaCO(2) showed a trend to decrease from 72 (22) (CMV) to 47 (8) mmHg (HFVOe) and mean infants respiratory rate a trend to increase from 20 (11) (HFOVi) to 34 (14) (HFOVe) breaths/min. With usual doses of sedatives and opiates, no infant was paralysed and all were extubated to CPAP or supplemental oxygen after a mean of 120 h. CONCLUSION: RSV induced respiratory failure with hypercapnia can be managed with HFOV using high mean airway pressure and large pressure swings while preserving spontaneous breathing.     

Delayed RSV diagnosis in a stem cell transplant population due to mutations that result in negative polymerase chain reaction

Respiratory syncytial virus (RSV) is a serious cause of morbidity and mortality in the adult hematopoietic stem cell transplant (HSCT) population. The timely diagnosis of RSV infection in this population is important for initiating therapy and instituting appropriate infection prevention measures. Molecular multiplex assays now offer increased sensitivity for a more accurate diagnosis. This study presents 5 cases of RSV infection in HSCT patients in which diagnosis was delayed due to false-negative results from a multiplex polymerase chain reaction (PCR) assay. The false-negative result was due to a single base-pair mutation in the RSV strain. These false results delayed the appropriate treatment of patients. This study shows that a combination of a multiplex PCR assay, viral antigen, and/or culture should be used to detect variants of RSV in patients and that multiplex respiratory viral assays should develop a more robust design that includes multiple genetic target per virus to prevent missing viruses that continue to have genetic variances.     

Effect of inhaled nitric oxide on respiratory mechanics in ventilated infants with RSV bronchiolitis

Objective: To evaluate the bronchodilator effect of inhaled nitric oxide (NO) in infants with respiratory failure caused by respiratory syncytial virus (RSV) bronchiolitis and to compare the effect with the one obtained by salbutamol. Design: Prospective study. Setting: Pediatric intensive care unit of a university children's hospital. Patients: Twelve acutely ill, intubated infants (mean age 4.5 months, mean weight 4.9 kg) with respiratory failure due to documented RSV bronchiolitis. Interventions: Total respiratory system resistance (Rrs) was measured by single breath occlusion at the baseline and after inhaling NO at 20, 40 and 60 ppm for 1 h, and after inhalation of a standard β ₂-agonist, salbutamol. Arterial blood gas analysis was performed at each study level on 6 of the 12 patients. Results: The baseline mean Rrs (SE) was 0.29 (0.04) cm H₂O/ml per s. At each dose of NO, the mean Rrs (SE) was 0.28 (0.04) cm H₂O/ml per s. With salbutamol, the mean Rrs (SE) was 0.21 (0.03) cm H₂O/ml per s. These values were not significantly different from each other (by ANOVA). Inhaled NO produced a significant decrease in Rrs of greater than 4 times the coefficient of variation of the baseline measurement in 3 of 12 patients. Seven of 12 patients had no significant change while two patients had a significant increase in Rrs. Inhaled salbutamol produced a significant decrease in Rrs in 5 of 11 patients, while 6 showed no change in Rrs. Conclusion: Inhaled NO has no apparent bronchodilator effect in the majority of acutely ill infants with RSV bronchiolitis and does not appear to provide any additional benefit over the use of salbutamol. The clinical benefit of inhaled NO as a bronchodilator is questionable under these conditions. Received: 15 June 1998 Final revision received: 23 September 1998 Accepted: 29 September 1998     

血栓素A2受体基因多态性与儿童呼吸道合胞病毒感染后喘息发生的相关性研究

目的 研究呼吸道合胞病毒(RSV)在儿童喘息发作中的作用及血栓素A2受体(TBXA2R)基因T924C多态性与RSV感染后喘息发生的相关性.方法 研究对象为2008年5月-12月在天津医科大学第二医院儿科就诊的哮喘急性发作患儿125例(病例组),又分为<3岁组39例,≥3岁86例,选取同期健康儿童49名作对照.采用酶联免疫吸附法测定RSVIgM、IgG,聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法对血栓素A2受体基因T924C进行多态性分析.结果 ①125例喘息发作患儿血清RSV特异性抗体阳性者57例(45.60%),49名健康对照者RSV抗体阳性者8例(16.33%).2组比较差异有统计学意义(χ2=12.890,P=0.000).②2组RSV特异性抗体阳性构成比≥3岁组[31.40%(27/86)]与<3岁组[76.92%(30/39)]比较差异有统计学意义(χ2=22.420,P=0.000).③病例组及健康对照组的RSV特异性抗体阳性者基因型分布经χ2检验,χ2=5.346,P=0.021,提示2组基因型构成不同,哮喘组TC+CC基因型所占比例明显高于健康对照组.病例组和健康对照组T和C等位基因频率构成差异无统计学意义(χ2=2.660,P=0.103).结论 RSV感染是诱发儿童哮喘急性发作的主要原因,尤其是3岁以内婴幼儿.同样有RSV感染,血栓素A2受体基因924位点TC、CC基因型可以增加喘息的发生率.     

福州地区急性呼吸道感染患儿呼吸道合胞病毒检测及亚型分析

目的:分析福州地区2006-2007年冬春季我院收治急性呼吸道感染患儿呼吸道合胞病毒(RSV)及其亚型流行情况。方法:采用RT-PCR方法检测176例急性呼吸道感染患儿的鼻咽拭子中RSV并进行亚型鉴定分析。结果:(1)在176例标本中,RSV阳性28例(15.9%)。其中急性下呼吸道感染阳性率为38%,显著高于急性上呼吸道感染的4%(!2=33.15,P<0.05)。(2)28例RSV阳性标本中,A亚型23例(82%),B亚型4例(14%),不明分型者1例(4%);上、下呼吸道感染组患儿间RSV亚型分布差异无显著性(P>0.05),都以A型为主。(3)RSV阳性患儿的年龄主要以3岁以下为主。结论:RSV是婴幼儿急性下呼吸道感染的重要病原体;福州地区2006-2007年冬春季RSV两种亚型同时流行,以A亚型为主。     

呼吸道合胞病毒多克隆抗体的制备及临床意义

目的 制备呼吸道合胞病毒（RSV）多克隆抗体，为RSV的检测提供条件。方法 用RSV颗粒抗原免疫新西兰家兔3只，采用细胞病变中和实验检测RSV多克隆抗体。结果 细胞病变中和实验结果显示，本研究制备的RSV多克隆抗体在1：1102的稀释度能保护50％Hela细胞免受RSV的攻击，而阴性对照血清不能保护细胞对病毒的感染。结论 RSV颗粒抗原免疫新西兰家兔可成功制备RSV多克隆抗体，1：1102稀释的血清可保护50％的细胞不产生病变。     

An inadequate dose of ribavirin is related to virological relapse by chronic hepatitis C patients treated with pegylated interferon alpha-2b and ribavirin

The aim of this large-scale analysis was to assess the effect of 48-week pegylated interferon (PEG-IFN) α-2b and ribavirin (RBV) therapy on virological relapse by patients infected with hepatitis C virus (HCV) genotype 1. The relationship between virological relapse and the dose of PEG-IFNα-2b and RBV was investigated in 619 patients who had once cleared HCV RNA during PEG-IFNα-2b and RBV treatment for 48 weeks. The overall virological relapse rate was 34.1% (211 of 619). The relapse rate was 59.5% (22 of 37) for patients who received <6 mg/kg/day of RBV, even if a sufficient dose of PEG-IFNα-2b (≥1.5 μg/kg/day) was received. In contrast, the relapse rate was 28.1% (16 of 57) for patients who received ≥12 mg/kg/day of RBV, irrespective of the PEG-IFNα-2b dose. The relapse rates were significantly increased with the reduction of the RBV dose for both PEG-IFNα-2b doses of ≥1.2 and <1.2 μg/kg/week (P < 0.0001 and P = 0.0006, respectively). Moreover, the relapse rate was 41.2% (35 of 85) for patients with an early virological response (EVR) who received <6 mg/kg/day of RBV. The relapse rates were significantly increased with the reduction of the RBV dose in both those patients with an EVR and those with a late virological response (P = 0.0006 and P = 0.0088, respectively). To summarize, for HCV genotype 1 patients treated with PEG-IFNα-2b and RBV, the virological relapse of HCV was RBV dose-dependent, irrespective of the dose of PEG-IFNα or the effect of early viral kinetics.     

婴幼儿呼吸道合胞病毒和人鼻病毒急性下呼吸道感染临床特征及随访研究

目的：比较婴幼儿呼吸道合胞病毒（RSV）和人鼻病毒（HRV）急性下呼吸道感染的临床特征,探讨婴幼儿期RSV急性下呼吸道感染患儿后期哮喘和反复喘息的发生与HRV感染患儿是否存在差异。方法采用 RT-PCR 或 PCR 方法检测住院患儿咽拭子或鼻咽吸取物中常见的呼吸道感染病毒,选取单一RSV和HRV感染病例,回顾性比较两组患者的临床特征并进行随访。结果 RSV感染组纳入病例80例, HRV感染组纳入32例。两组患儿的临床特征相似,但RSV感染组患儿年龄偏小（P＝0.004）,有喘息表现者明显多于 HRV 感染组（P＝0.000）。在与哮喘和反复喘息发生的关系上,两组间的差异无统计学意义（P值均为1.000）。结论婴幼儿RSV和HRV急性下呼吸道感染的临床特征相似,但在平均年龄、临床喘息的发生率等方面存在统计学差异。未发现婴幼儿期 RSV 感染患儿后期哮喘和反复喘息的发生与HRV感染患儿间存在差异。