Pleural fluid characteristics in hantavirus pulmonary syndrome
Pleural fluid characteristics in hantavirus pulmonary syndrome
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DOI：
10.1378/chest.112.4.1133
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发表时间：
1997-10-01
期刊：
影响因子：
9.6
通讯作者：
Simpson, SQ
中科院分区：
文献类型：
--
作者：
Bustamante, EA;Levy, H;Simpson, SQ
汉坦病毒肺综合征（HPS）是一种由啮齿类动物传播的急性、暴发性心肺系统疾病，以非心源性肺水肿和心功能不全为主。HPS患者常见胸腔积液，被认为是渗出性的。本报告描述了胸腔积液的患病率和特点，通过评估胸部X线片的存在，胸腔积液和审查所有的胸腔积液标本从HPS患者。在新墨西哥州大学医院接受HPS治疗的23例患者中，22例有胸腔积液的证据，而4例有胸腔积液采样，2例样本符合渗出物标准，胸腔积液蛋白与血清蛋白的比值大于0.5;一个明显是漏出液，另一个具有不一致的特征，两个渗出液样本在入院后7天获得，而另外2例是在入院后1天内获得的，胸水培养无菌，有核细胞总数小于170个/mm 3，主要是单核细胞。可以提出一种假设，即HPS中的胸膜液最初是漏出的，与观察到的心肺功能障碍一致，然而，在积极的复苏努力之后，随着急性疾病的消退，随着心脏功能正常化，发生液体转移;胸膜液可能具有渗出物的特征。
Hantavirus pulmonary syndrome (HPS), is a rodent-borne, acute, often fulminant cardiorespiratory illness, Noncardiogenic pulmonary edema is prominent in HPS as is cardiac dysfunction. Pleural effusions are commonly noted in patients with HPS and have been thought to be exudative. This report describes the prevalence and characteristics of pleural effusions by an assessment of chest radiographs for the presence of pleural fluid and reviews all pleural fluid specimens obtained from patients with HPS. Of 23 patients treated at the University of New Mexico Hospital for HPS, 22 had evidence of pleural fluid while 4 had sampling of their pleural fluid, Two samples met criteria for an exudate by pleural fluid protein to serum protein ratio of more than 0.5; one was clearly a transudate and the other had inconsistent characteristics, The two exudative samples were obtained 7 days after admission, while the other 2 were obtained within 1 day of admission, Pleural fluid cultures were sterile, and the total of nucleated cells was less than 170/mm(3), and predominately mononuclear. A hypothesis may be formulated that the pleural fluid in HPS is initially transudative, consistent with the observed cardiopulmonary dysfunction, However following aggressive resuscitative efforts and as the acute illness resolves, fluid shifts occur as cardiac function normalizes; the pleural fluid may take on characteristics of an exudate.