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马血清特异性免疫球蛋白预防埃博拉出血热的临床应用经验。

An experience in the clinical use of specific immunoglobulin from horse blood serum for prophylaxis of Ebola haemorrhagic fever.

作者信息

Borisevich I V, Chemikova Natalya K, Markov V I, Krasnianskiy V P, Borisevich S V, Rozhdestvenskiy E V

出版信息

Vopr Virusol. 2017;62(1):25-9.

Abstract

The aim of this work was to estimate the efficacy and safety of single intramuscular introduction of specific heterologous immunoglobulin as prophylactic drug against Ebola hemorrhagic fever. Materials and methods. The specific heterologous immunoglobulin was introduced as a special prophylactic drug to 28 patients in epidemic situations, after skin hurt with infectious materials or contact with infectious blood. Clinico-laboratory observation was performed in 24 subjects after single intramuscular introduction of heterologous immunoglobulin Ebola. The samples of blood serum were investigated for immunoglobulin Ebola and antibodies to horse gamma-globulin on the 30th and 60th days after prophylaxis. Results. None of the subjects of the study contracted Ebola fever. There were no anaphylactic reactions after special prophylaxis with specific heterologous immunoglobulin. Among the subjects with normal allergic state 31% responded with local reactions; 13%, with a general reaction (mild case of the serum disease). Almost no reaction was observed in patients with unfavorable allergic state subjected to desensitizing therapy; in the absence of desensitizing therapy, 50% of patients with unfavorable allergic state exhibited local reactions; 17%, mild cases of the serum disease; 33%, moderate cases of the serum disease. In summary, if the tactics of immunoglobulin application was right, the quantity of local allergic reactions was 28%; of wide spread reactions, 6%. Weak serum disease was observed in 11% of the subjects. The prognostic period of resistance to Ebola fever was less than 30 days. Conclusion. The prophylactic use of specific immunoglobulin from horse blood serum against hemorrhagic Ebola fever is effective and relatively safe in patients subjected to desensitizing therapy.

摘要

这项工作的目的是评估单次肌肉注射特定异源免疫球蛋白作为预防埃博拉出血热药物的疗效和安全性。材料与方法。在疫情形势下,当28名患者被感染性物质造成皮肤损伤或接触感染性血液后,将特定异源免疫球蛋白作为一种特殊预防药物进行注射。在单次肌肉注射埃博拉异源免疫球蛋白后,对24名受试者进行临床实验室观察。在预防后的第30天和第60天,对血清样本进行埃博拉免疫球蛋白和抗马γ球蛋白抗体检测。结果。研究中的受试者均未感染埃博拉热。使用特定异源免疫球蛋白进行特殊预防后未出现过敏反应。在过敏状态正常的受试者中,31%出现局部反应;13%出现全身反应(血清病轻症)。在接受脱敏治疗的过敏状态不佳的患者中几乎未观察到反应;在未进行脱敏治疗的情况下,50%过敏状态不佳的患者出现局部反应;17%出现血清病轻症;33%出现血清病中度症状。总之,如果免疫球蛋白的应用策略正确,局部过敏反应的发生率为28%;广泛反应的发生率为6%。11%的受试者出现轻度血清病。对埃博拉热的抵抗预后期少于30天。结论。对于接受脱敏治疗的患者,使用马血清特异性免疫球蛋白预防出血性埃博拉热是有效且相对安全的。

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