在急性呼吸衰竭的免疫受损患者中呼吸扭矩微型病毒的临床意义
Alexis Maillard1, Linda Feghoul2, Virginie Lemiale1
1Service de médecine intensive et réanimation, Hôpital Saint-Louis, Assistance Publique des Hôpitaux de Paris.
概括
呼吸道抽样中的高扭矩病毒 (TTV) DNA 表明急性呼吸衰竭的免疫受损患者患有机会性感染的风险更大,结果更差. 这一发现有助于识别高风险个体以更好地管理.
科学领域:
- 免疫学
- 病毒学
- 危急护理医学
背景情况:
- 鉴定患有机会性感染高风险的免疫功能低下患者对于治疗急性呼吸衰竭至关重要.
- 血液中的Torque teno病毒 (TTV) DNA水平是移植受体免疫功能的标志物.
- 这项研究探讨了TTVDNA在ARF免疫受损患者的鼻抽样中的意义.
研究的目的:
- 在鼻抽样中检测到的Torque teno病毒 (TTV) DNA的临床相关性.
- 确定TTVDNA负担与患有ARF的免疫受损患者的机会性感染发生率之间的关联.
主要方法:
- 在32个重症监护室注册了505名免疫功能低下的ARF患者.
- 在入院时采集了鼻抽样,并对TTV DNA进行了测试.
- 专家调查人员对TTV结果视而不见,评估ARF的原因,专注于机会性感染.
主要成果:
- 在60%的患者中检测到呼吸道TTVDNA;在36%的患者中发现高负荷 (≥2. 9 log10副本/ ml).
- 高TTV负担与机会性感染 (20%对11%),所有原因的肺部感染 (67%对56%) 和细菌感染 (35%对23%) 的增加有显著相关性.
- 检测TTV也与更高的机械呼吸率或28天死亡率有关 (59%对48%).
结论:
- 在ARF免疫受损患者的呼吸道中,Torque teno病毒 (TTV) DNA水平的升高与肺部感染的增加有关.
- 高TTV负担与机会性病原体有关,并预测不良临床结果,包括机械呼吸或死亡.
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