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利巴韦林治疗土耳其东黑海地区克里米亚-刚果出血热的疗效。

The efficacy of ribavirin in the treatment of Crimean-Congo hemorrhagic fever in Eastern Black Sea region in Turkey.

机构信息

Department of Infectious Disease and Clinical Microbiology, Karadeniz Technical University School of Medicine, 61080 Trabzon, Turkey.

出版信息

J Clin Virol. 2010 Jan;47(1):65-8. doi: 10.1016/j.jcv.2009.11.007. Epub 2009 Dec 3.

Abstract

BACKGROUND

The efficiency of ribavirin for treatment of Crimean-Congo hemorrhagic fever (CCHF) is unknown. In the literature, prospective randomized studies investigating the efficacy of ribavirin are not found.

OBJECTIVES

To investigate the efficacy of ribavirin in treatment of patients with CCHF.

STUDY DESIGN

In this prospective randomized cohort study 136 cases were included between June 2004 and August 2007. The diagnosis was confirmed in the CCHF reference laboratory of Refik Saydam National Hygiene Central Institute of the Turkish Ministry of Health. Patients either received ribavirin plus supportive treatment (Group A) (n=64) or only supportive treatment (Group B) (n=72). For the evaluation of efficacy of ribavirin, various parameters were compared between Group A and Group B.

RESULTS

As well as the similarity of demographic features between the two groups, there were no statistical differences in incubation time; hospitalization time; patients requiring platelet replacement therapy; the time taken for platelet levels to return to normal levels and mortality. In Group B, the rate of tick contact was higher (p=0.03). In Group A, leukocyte levels took longer to return to the normal levels (p=0.02).

CONCLUSION

In our study, there was no positive effect determined on clinical or laboratory parameters in CCHF patients treated with ribavirin, also it was observed that leukocyte levels took longer to return to normal (p=0.02) and, while not statistically significant, the longer period of hospitalization (p=0.09) needed was observed as a negative effect. Because of these reasons, it is thought that the use of ribavirin makes no significant contribution to the prognosis of the CCHF disease.

摘要

背景

利巴韦林治疗克里米亚-刚果出血热(CCHF)的疗效尚不清楚。文献中未发现针对利巴韦林疗效的前瞻性随机研究。

目的

研究利巴韦林治疗 CCHF 患者的疗效。

研究设计

在这项前瞻性随机队列研究中,共纳入了 2004 年 6 月至 2007 年 8 月间的 136 例患者。该诊断在土耳其卫生部 Refik Saydam 国家卫生中心传染病参考实验室得到确认。患者接受利巴韦林联合支持治疗(A 组)(n=64)或仅接受支持治疗(B 组)(n=72)。为了评估利巴韦林的疗效,比较了 A 组和 B 组之间的各种参数。

结果

两组患者的人口统计学特征相似,潜伏期、住院时间、需要血小板替代治疗的患者、血小板水平恢复正常所需时间和死亡率无统计学差异。B 组中蜱虫接触的比例较高(p=0.03)。A 组白细胞水平恢复正常所需时间较长(p=0.02)。

结论

在我们的研究中,利巴韦林治疗 CCHF 患者在临床或实验室参数方面没有产生积极影响,并且观察到白细胞水平恢复正常的时间延长(p=0.02),尽管无统计学意义,但住院时间延长(p=0.09)。由于这些原因,认为利巴韦林的使用对 CCHF 疾病的预后没有显著贡献。

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