Human herpesviruses respiratory infections in patients with acute respiratory distress (ARDS).
Human herpesviruses respiratory infections in patients with acute respiratory distress (ARDS).
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DOI：
10.1007/s00430-016-0456-z
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发表时间：
2016-08
影响因子：
5.4
通讯作者：
Peris A
中科院分区：
文献类型：
--
作者：
Bonizzoli M;Arvia R;di Valvasone S;Liotta F;Zakrzewska K;Azzi A;Peris A
急性呼吸窘迫综合征（ARDS）是当今重症监护病房（ICU）住院的主要原因。急性呼吸窘迫综合征和肺炎与危重患者密切相关；然而，病因并不总是确定的。越来越多的报道称，即使没有典型的免疫抑制，危重患者呼吸道样本中也存在人类单纯疱疹病毒1型、人类巨细胞病毒和eb病毒。本研究的主要目的是为了更好地了解ICU住院ARDS患者下呼吸道疱疹病毒发现的意义。除了对流感病毒和其他常见呼吸道病毒的研究外，还对54名ICU住院患者的呼吸道样本进行了调查，没有已知的微生物病原体。此外，分析每位患者的免疫表型。疱疹病毒DNA在下呼吸道的存在似乎不能归因于免疫表型受损，而疱疹病毒阳性与流感病毒感染之间存在显著相关性。较高的ICU死亡率与下呼吸道疱疹病毒感染的存在以及免疫表型受损显著相关，因为预后较差的患者自ICU住院的第一天起就表现出严重的淋巴细胞减少，尤其是T （CD3+）细胞。总之，这些结果表明疱疹病毒下呼吸道感染（在流感病毒感染后更常发生）可能是一个阴性预后指标。急性呼吸窘迫综合征ICU患者的独立危险因素是免疫表型受损。
Acute respiratory distress syndrome (ARDS) is today a leading cause of hospitalization in intensive care unit (ICU). ARDS and pneumonia are closely related to critically ill patients; however, the etiologic agent is not always identified. The presence of human herpes simplex virus 1, human cytomegalovirus and Epstein–Barr virus in respiratory samples of critically ill patients is increasingly reported even without canonical immunosuppression. The main aim of this study was to better understand the significance of herpesviruses finding in lower respiratory tract of ARDS patients hospitalized in ICU. The presence of this group of herpesviruses, in addition to the research of influenza viruses and other common respiratory viruses, was investigated in respiratory samples from 54 patients hospitalized in ICU, without a known microbiological causative agent. Moreover, the immunophenotype of each patient was analyzed. Herpesviruses DNA presence in the lower respiratory tract seemed not attributable to an impaired immunophenotype, whereas a significant correlation was observed between herpesviruses positivity and influenza virus infection. A higher ICU mortality was significantly related to the presence of herpesvirus infection in the lower respiratory tract as well as to impaired immunophenotype, as patients with poor outcome showed severe lymphopenia, affecting in particular T (CD3+) cells, since the first days of ICU hospitalization. In conclusion, these results indicate that herpesviruses lower respiratory tract infection, which occurs more frequently following influenza virus infection, can be a negative prognostic marker. An independent risk factor for ICU patients with ARDS is an impaired immunophenotype.
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影响因子：
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