Chang Betty, Crowley Mark, Campen Matthew, Koster Frederick
Department of Internal Medicine, University of New Mexico Health Science Center, Albuquerque, New Mexico, USA.
Semin Respir Crit Care Med. 2007 Apr;28(2):193-200. doi: 10.1055/s-2007-976491.
Hantavirus cardiopulmonary syndrome (HCPS) is caused by infection with multiple types of hantaviruses throughout the Americas. All strains induce a pulmonary capillary leak syndrome with cardiogenic shock in severe cases, and almost all strains have an overall mortality rate of 35%. Some strains in South America are commonly associated with either mild disease without pulmonary edema or severe disease with pulmonary hemorrhage. Early recognition during the thrombocytopenic prodrome phase and transport to intensive care improve survival, due to very rapid progression of respiratory failure and shock in some patients. Limited fluid replacement, early inotropic therapy, and mechanical ventilation also improve survival. Extracorporeal membrane oxygenation (ECMO) has been life saving for patients with refractory shock. Ribavirin does not appear to reduce mortality, but hyperimmune serum offers a promising future therapy because survival is correlated with higher neutralizing antibody titers at admission.
汉坦病毒心肺综合征（HCPS）由美洲多种汉坦病毒感染所致。所有毒株均可引发肺毛细血管渗漏综合征，严重时可导致心源性休克，几乎所有毒株的总体死亡率达35%。南美洲的一些毒株通常与无肺水肿的轻症或伴有肺出血的重症相关。在血小板减少前驱期尽早识别并转运至重症监护病房可提高生存率，因为部分患者呼吸衰竭和休克进展非常迅速。有限的液体复苏、早期的强心治疗和机械通气也可提高生存率。体外膜肺氧合（ECMO）已挽救了难治性休克患者的生命。利巴韦林似乎不能降低死亡率，但高免疫血清提供了一种有前景的未来治疗方法，因为生存率与入院时较高的中和抗体滴度相关。
