Wang Shih-Min
Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainan, Taiwan; Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainan, Taiwan; Center of Infectious Disease and Signaling Research, National Cheng Kung UniversityTainan, Taiwan.
Front Pharmacol. 2016 Mar 29;7:82. doi: 10.3389/fphar.2016.00082. eCollection 2016.
Enterovirus 71 (EV71) was implicated in a widespread outbreak of hand-foot-and-mouth disease (HFMD) across the Asia Pacific area since 1997 and has also been reported sporadically in patients with brain stem encephalitis. Neurogenic shock with pulmonary edema (PE) is a fatal complication of EV71 infection. Among inotropic agents, milrinone is selected as a therapeutic agent for EV71- induced PE due to its immunopathogenesis. Milrinone is a type III phosphodiesterase inhibitor that has both inotropic and vasodilator effects. Its clinical efficacy has been shown by modulating inflammation, reducing sympathetic over-activity, and improving survival in patients with EV71-associated PE. Milrinone exhibits immunoregulatory and anti-inflammatory effects in the management of systemic inflammatory responses in severe EV71 infection.
自1997年以来,肠道病毒71型(EV71)与亚太地区手足口病(HFMD)的广泛暴发有关,并且在脑干脑炎患者中也有散发病例报道。神经源性休克合并肺水肿(PE)是EV71感染的一种致命并发症。在强心剂中,米力农因其免疫发病机制而被选作治疗EV71所致PE的药物。米力农是一种III型磷酸二酯酶抑制剂,具有正性肌力和血管舒张作用。通过调节炎症、降低交感神经过度活动以及提高EV71相关PE患者的生存率,已证实其临床疗效。在严重EV71感染的全身炎症反应管理中,米力农具有免疫调节和抗炎作用。