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[俄罗斯的甲型H1N1流感大流行(2009年猪流感):流行病学、诊断、临床表现及治疗]

[Pandemic influenza A/H1N1 (sw2009) in Russia: epidemiology, diagnosis, clinical picture, and treatment].

作者信息

Iatsyshina S B, Minenko A N, Kushakova T E, Praded M N, Kudriavtseva A V, Shipulin G A, Maleev V V, Pokrovskiĭ V I

出版信息

Ter Arkh. 2010;82(11):10-4.

Abstract

AIM

To study the epidemiological and clinical features of the 2009-2010 pandemic influenza in Russia.

SUBJECTS AND METHODS

Materials from 874 patients, including postmortem samples from 287 subjects, were examined applying the AmpliSens Influenza virus A/H1-swine-FL PCR kit designed and produced by the Central Research Institute of Epidemiology. The clinical and postmortem characteristics of 68 patients who had died from influenza A/H1N1 (sw2009) were analyzed in detail.

RESULTS

The cause of deaths was primary virus pneumonia in most cases. The major manifestation of viral pathogenicity was impaired microcirculation leading to hemorrhage. No mutations conferring resistance to oseltamivir and arbidol were found. All A/H1N1swl viruses had genetic markers of remantadin resistance.

CONCLUSION

The reagent kits developed by the Central Research Institute of Epidemiology proved to be effective. It is necessary to set up PCR laboratories that differentially diagnose influenza and acute respiratory viral infections in health care facilities in order to make early laboratory diagnosis of influenza and to timely perform its specific therapy.

摘要

目的

研究俄罗斯2009 - 2010年大流行性流感的流行病学和临床特征。

对象与方法

使用俄罗斯中央流行病学研究所设计生产的AmpliSens甲型流感病毒A/H1 - 猪 - FL PCR试剂盒,对874例患者的样本进行检测,其中包括287例尸检样本。对68例死于甲型H1N1(sw2009)流感的患者的临床和尸检特征进行了详细分析。

结果

多数病例的死亡原因是原发性病毒肺炎。病毒致病性的主要表现是微循环障碍导致出血。未发现对奥司他韦和阿比多尔耐药的突变。所有甲型H1N1swl病毒都有金刚烷胺耐药的基因标记。

结论

中央流行病学研究所开发的试剂试剂盒证明是有效的。有必要在医疗机构建立能对流感和急性呼吸道病毒感染进行鉴别诊断的PCR实验室,以便对流感进行早期实验室诊断并及时进行特异性治疗。

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