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加研究揭示结合使用类固醇和干扰素有望成SARS治
加拿大最顶尖的研究人员率领的团队进行了此项研究，其报告将刊载于12月24日出版的《美国医学会杂志》（Journal of the American Medical Association）。
这一研究是在4月和5月间对多伦多22名SARS可能患者所进行，旨在检测采用提升免疫系统的干扰素治疗SARS，其功效和安全性如何。
研究发现，接受干扰素和类固醇结合治疗的SARS患者效果较好，比起仅接受类固醇治疗的患者更快康复。研究人员称：“事实上，包括呼吸道和肺部异常等SARS症状，在很短时间内就消失。这一研究同时发现其对患者没有副作用。”
本项报告的首席作者、多伦多大学免疫学教授费希（Eleanor Fish）表示：“与其治疗症状，更积极地抵抗病毒感染似乎更适当。细胞接触到病毒时，人体所做的第一个反应就是分泌干扰素。”
干扰素是自然生成的蛋白质，能提升人体免疫力，使人体更能抵御病毒感染。
“如果病毒非常迅速地繁衍，则人体可能无法做出充分的干扰素反应，”费希说。
“罹患SARS时就是如此……所以增强干扰素反应是非常恰当的方法，我们就打算这么作。”
研究中服用干扰素和类固醇两种药物的患者，比较不需要重病特别护理或通风设备。
JAMA. 2003 Dec 24;290(24):3222-8.
Interferon alfacon-1 plus corticosteroids in severe acute respiratory syndrome: a preliminary study.
Loutfy MR, Blatt LM, Siminovitch KA, Ward S, Wolff B, Lho H, Pham DH, Deif H, LaMere EA, Chang M, Kain KC, Farcas GA,
Ferguson P, Latchford M, Levy G, Dennis JW, Lai EK, Fish EN.
North York General Hospital, Toronto General Research Institute and University of Toronto, and Mt Sinai Hospital and University of Toronto, Toronto, Ontario.
CONTEXT: Severe acute respiratory syndrome (SARS) is a new clinical entity for which no effective therapeutic strategy has been developed. OBJECTIVE: To provide preliminary results on the potential therapeutic benefit and tolerability of interferon alfacon-1 plus corticosteroids for SARS.Design, Setting, and PATIENTS: Open-label study of 22 patients diagnosed as having probable SARS at North York General Hospital, Toronto, Ontario, between April 11 and May 30, 2003. INTERVENTIONS: Thirteen patients were treated with corticosteroids alone and 9 patients were treated with corticosteroids plus subcutaneous interferon alfacon-1. MAIN OUTCOME MEASURES: Clinical parameters, including oxygen saturation and requirement, laboratory measures, and serial chest radiography results. RESULTS: Resolution of fever and lymphopenia were similar between the 2 treatment groups. Of the 13 patients treated with corticosteroids alone, 5 (38.5%) were transferred to the intensive care unit, 3 (23.1%) required intubation and mechanical ventilation, and 1 (7.7%) died. Of the 9 patients in the interferon alfacon-1 treatment group, 3 (33.3%) were transferred to the intensive care unit, 1 (11.1%) required intubation and mechanical ventilation, and none died. The interferon alfacon-1 treatment group had a shorter time to 50% resolution of lung radiographic abnormalities (median time, 4 days vs 9 days; P =.001), had better oxygen saturation (P =.02), resolved their need for supplemental oxygen more rapidly (median, 10 days vs 16 days; P =.02), had less of an increase in creatine kinase levels (P =.03), and showed a trend toward more rapid resolution of lactate dehydrogenase levels compared with the group receiving corticosteroids alone. CONCLUSIONS: In this preliminary, uncontrolled study of patients with SARS, use of interferon alfacon-1 plus corticosteroids was associated with reduced disease-associated impaired oxygen saturation, more rapid resolution of radiographic lung abnormalities, and lower levels of creatine kinase. These findings suggest that further investigation may be warranted to determine the role of interferon alfacon-1 as a therapeutic agent for the treatment of SARS. [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-03-11 05:11
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