在危急病患免疫能力强的患者中,细胞巨乳病毒的重新激活
Ajit P Limaye1, Katharine A Kirby, Gordon D Rubenfeld
1Department of Laboratory Medicine, University of Washington Medical Center, 1959 NE Pacific St, Seattle, WA 98195-7110, USA. limaye@u.washington.edu
JAMA
|July 24, 2008
概括
细胞巨乳病毒 (CMV) 的重新激活在重症,免疫能力强的患者中很常见,并且与更长的住院时间或死亡有关. 建议对CMV预防进行进一步的研究.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 病毒学 病毒学
背景情况:
- 细胞巨乳病毒 (CMV) 感染对免疫抑制个体构成风险.
- 重症患者中CMV再激活的发生率和影响尚不清楚,免疫能力较强的患者仍然不清楚.
研究的目的:
- 调查细胞巨乳病毒 (CMV) 复激活与在重症监护室 (ICU) 和医院住院时间之间的关联.
- 评估CMV重新激活和严重病症,免疫能力强的个体的不良结果之间的关系.
主要方法:
- 在ICU中对120名CMV阳性,免疫能力强的成年人进行前性研究.
- 每周三次使用实时聚合酶链反应 (PCR) 进行CMV血DNAemia评估.
- 临床结果和停留时间由盲人人员监测.
主要成果:
- 在33%的患者中发生了CMV病毒病;高水平病毒病 (>1000副本/毫升) 在20%中发生.
- 慢性肺炎病毒的重新激活独立地与30天内住院或死亡有关 (调整后的OR,4.3-13.9).
- 冠状病毒水平与长时间住院 (≥14天) 有关 (经调整的OR,3.2-5.1).
结论:
- 在重症患者中,CMV的重新激活是常见的.
- 再激活与增加住院时间和死亡率有关.
- 在这个患者群体中,有必要对CMV预防进行受控试验.
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