Discriminators between hantavirus-infected and -uninfected persons enrolled in a trial of intravenous ribavirin for presumptive hantavirus pulmonary syndrome
Discriminators between hantavirus-infected and -uninfected persons enrolled in a trial of intravenous ribavirin for presumptive hantavirus pulmonary syndrome
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DOI：
10.1086/324619
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发表时间：
2002-02-01
影响因子：
11.8
通讯作者：
Peters, CJ
中科院分区：
文献类型：
--
作者：
Chapman, LE;Ellis, BA;Peters, CJ
为了提供潜在的治疗干预措施，并在汉坦病毒肺综合征(HPS)爆发期间收集临床和实验室数据，来自美国的140名疑似HPS患者参加了研究性静脉注射利巴韦林治疗。随后，有30人在实验室确认了HPS，而有足够样本的105人没有得到确认。与汉坦病毒阴性患者相比，HPS患者更有可能报告从症状开始到住院期间的肌痛，门诊时的恶心，以及住院时的腹泻和恶心；他们在疾病早期报告呼吸道症状的可能性显著降低。这两组患者从发病到寻求治疗的时间没有差异；HPS患者从发病、住院或登记到死亡的时间显著缩短。在住院期间，HPS患者的外周血涂片上更常见的是骨髓细胞、偏粒细胞或早幼粒细胞，他们中明显更多的人有血小板减少、血液浓缩和低碳酸血症。临床症状的类型、临床演变的速度和特定的临床实验室参数在这两组之间有区别。
To provide a potentially therapeutic intervention and to collect clinical and laboratory data during an outbreak of hantavirus pulmonary syndrome (HPS), 140 patients from the United States with suspected HPS were enrolled for investigational intravenous ribavirin treatment. HPS was subsequently laboratory confirmed in 30 persons and not confirmed in 105 persons with adequate specimens. Patients with HPS were significantly more likely than were hantavirus-negative patients to report myalgias from onset of symptoms through hospitalization, nausea at outpatient presentation, and diarrhea and nausea at the time of hospitalization; they were significantly less likely to report respiratory symptoms early in the illness. The groups did not differ with regard to time from the onset of illness to the point at which they sought care; time from onset, hospitalization, or enrollment to death was significantly shorter for patients with HPS. At the time of hospitalization, patients with HPS more commonly had myelocytes, metamyelocytes, or promyelocytes on a peripheral blood smear, and significantly more of them had thrombocytopenia, hemoconcentration, and hypocapnia. Patterns of clinical symptoms, the pace of clinical evolution, and specific clinical laboratory parameters discriminated between these 2 groups.