2018-2019年乌克兰麻疹疫情期间麻疹感染临床病程特征

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That is why it was interesting to study the clinical and laboratory features of the course of measles infection in the adult population at the present stage. Objective: to determine features of the clinical course of measles infection and the factors that are prerequisites for the development of complications. Materials and methods. The study included 65 patients who were treated in the Kharkiv regional clinical infectious hospital in 2018-2019. Based on the clinical course of the disease, the severity and the presence of complications, the patients included in the study were divided into 4 groups. The control group consisted of 20 healthy voluntary donors who did not have exclusion criteria. On the day of admission to the hospital and on the 10th day of stay in the hospital, based on the data of a clinical blood test, we calculated the cellular reactivity leukocyte indices (CRLI) – the white blood cell shift index (WBCSI), the white blood cell index (WBCI) and the D. A. Ivanov immunoreactivity index (IRI). Results and discussion. The study shows that the patients from groups 1 and 2 on the 10th day of hospitalization showed a complete clinical recovery and was discharged from the hospital, whereas patients from groups 3 and 4 on the 10th day showed a clinical improvement and were transferred for further treatment to the general department. When assessing the CRLI on the day of admission to the hospital, an increase in the WBCSI in patients from groups 2, 3 and 4 was found, with the greatest increase observed in patients from group 4. In patients from group 1, on the contrary, a decrease in the WBCSI and and an increase in WBCI were determined, which indicates the activation of the lymphocytic link of the immune response. Conclusions. The development of measles infection in the adult population is characterized by changes in the leukocyte indices of cellular reactivity, which are markers of the functional activity of the immune system. The moderate course of the disease is accompanied by a tendency to normalization of the indices that characterize the activity of the inflammatory process, while its severe course is characterized by an increase in the values of these indices and a decrease in the activity of the lymphocytic link of the immune response. 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引用次数: 0

摘要

麻疹是一种传染病,其特点是急性发病、前驱期短、存在发热、卡他性和中毒综合征,以及发展为典型的麻疹和麻疹。尽管世卫组织积极努力消除麻疹,并在发展中国家实施了疫苗接种规划,但麻疹仍然是一个紧迫的问题,是儿童和成人死亡率高的原因。麻疹感染的危险并发症之一是以院外肺炎的形式累及呼吸道,发生在10-34%的患者中。院外肺炎是在哈尔科夫地区临床医院接受治疗的麻疹患者的主要并发症之一,重症和中度疾病患者均有登记。这就是为什么现阶段研究成人麻疹感染过程的临床和实验室特征是有趣的。目的:了解麻疹感染的临床病程特点及并发症发生的先决因素。材料和方法。该研究包括2018-2019年在哈尔科夫地区临床感染医院接受治疗的65名患者。根据疾病的临床病程、严重程度及是否存在并发症,将纳入研究的患者分为4组。对照组由20名没有排除标准的健康自愿献血者组成。在入院当天和住院第10天,根据临床血液检查数据,计算细胞反应性白细胞指数(CRLI) -白细胞移位指数(WBCSI)、白细胞指数(WBCI)和D. a . Ivanov免疫反应指数(IRI)。结果和讨论。研究显示,第1、2组患者在住院第10天临床完全康复出院,第3、4组患者在第10天临床好转,转至综合科继续治疗。在入院当天评估CRLI时,发现第2、3和4组患者的WBCSI增加,其中第4组患者的增加幅度最大。相反,在第1组患者中,测定WBCSI下降和WBCI增加,这表明免疫反应的淋巴细胞环节激活。结论。成人麻疹感染的发展特点是细胞反应性白细胞指数的变化,这是免疫系统功能活动的标志。中度病程伴有表征炎症过程活性的指数趋于正常化的趋势,而严重病程的特点是这些指数的值增加和免疫反应的淋巴细胞环节的活性下降。对动态白细胞指数参数的变化进行评估,可以预测疾病的临床病程和并发症的风险,评估治疗的适当性,并确定是否需要免疫矫正治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Features of the clinical course of measles infection during the measles outbreak in 2018-2019 in Ukraine
Measles is an infectious disease characterized by an acute onset, a short prodromal period, presence of febrile, catarrhal and intoxication syndromes, as well as the development of typical enanthema and exanthema. Despite the active work of WHO to eliminate measles and the introduction of a vaccination program in developing countries, measles remains an urgent problem and the cause of high mortality rates among both children and adults. One of the dangerous complications of measles infection is the respiratory tract involvement in yhe form of out-of-hospital pneumonia, which occurs in 10-34% of patients. The out-of-hospital pneumonia was one of the main complications among the patients with measles who were treated in the Kharkiv regional clinical hospital and was registered both in patients with severe and moderate disease. That is why it was interesting to study the clinical and laboratory features of the course of measles infection in the adult population at the present stage. Objective: to determine features of the clinical course of measles infection and the factors that are prerequisites for the development of complications. Materials and methods. The study included 65 patients who were treated in the Kharkiv regional clinical infectious hospital in 2018-2019. Based on the clinical course of the disease, the severity and the presence of complications, the patients included in the study were divided into 4 groups. The control group consisted of 20 healthy voluntary donors who did not have exclusion criteria. On the day of admission to the hospital and on the 10th day of stay in the hospital, based on the data of a clinical blood test, we calculated the cellular reactivity leukocyte indices (CRLI) – the white blood cell shift index (WBCSI), the white blood cell index (WBCI) and the D. A. Ivanov immunoreactivity index (IRI). Results and discussion. The study shows that the patients from groups 1 and 2 on the 10th day of hospitalization showed a complete clinical recovery and was discharged from the hospital, whereas patients from groups 3 and 4 on the 10th day showed a clinical improvement and were transferred for further treatment to the general department. When assessing the CRLI on the day of admission to the hospital, an increase in the WBCSI in patients from groups 2, 3 and 4 was found, with the greatest increase observed in patients from group 4. In patients from group 1, on the contrary, a decrease in the WBCSI and and an increase in WBCI were determined, which indicates the activation of the lymphocytic link of the immune response. Conclusions. The development of measles infection in the adult population is characterized by changes in the leukocyte indices of cellular reactivity, which are markers of the functional activity of the immune system. The moderate course of the disease is accompanied by a tendency to normalization of the indices that characterize the activity of the inflammatory process, while its severe course is characterized by an increase in the values of these indices and a decrease in the activity of the lymphocytic link of the immune response. Assessment of changes in the parameters of leukocyte indices in dynamics makes it possible to predict the clinical course of the disease and the risk of complications, to assess the adequacy of the therapy, as well as to identify the need for immune correction therapy.
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