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汉坦病毒感染引起的肾脏受累(肾综合征出血热)

Author
Jukka Mustonen, MD, PhD
Section Editors
Gerald B Appel, MD
Martin S Hirsch, MD
Deputy Editor
Alice M Sheridan, MD
Translators
王荔, 主治医师

引言

汉坦病毒感染可能导致危及生命的肺和肾脏疾病[1-6]。1993年，在美国西南部因急性汉坦病毒感染而引起的一次高致命性流行与快速发作的呼吸衰竭、肾功能不全和发热相关[7]。

汉坦病毒属的每一种成员(如，汉滩病毒、普马拉病毒、汉城病毒、多布拉伐病毒、辛诺柏病毒和安第斯病毒)都能在人类中引起不同形式的临床疾病。例如，普马拉病毒感染引起的肾脏疾病相对较轻，并与良性的远期预后相关[8,9]。辛诺柏病毒是美国最常见的汉坦病毒，它主要引起心肺综合征，发现于南美洲的安第斯病毒也是如此[10]。汉滩病毒和多布拉伐病毒感染则可导致更严重的肾脏疾病[6,11]。

汉坦病毒导致的临床综合征也被称为流行性出血热、出血性肾病肾炎、Songo热、朝鲜出血热和流行性肾病。为了避免混乱，这些疾病现在被世界卫生组织(World Health Organization, WHO)统称为“肾综合征出血热(hemorrhagic fever with renal syndrome, HFRS)”[1,12]。

与汉坦病毒感染相关的肾脏病将总结在此。汉坦病毒感染的流行病学和诊断，以及汉坦病毒相关性心肺综合征将在别处讨论。 (参见“汉坦病毒感染的流行病学与诊断”和“Hantavirus cardiopulmonary syndrome”)

流行病学

人类可通过吸入含病毒的气溶胶颗粒，或接触受感染啮齿动物的尿液、分泌物或粪便而感染汉坦病毒。可能是通过改变人体气道条件，吸烟是普马拉病毒感染的一种危险因素[13,14]。每个病毒种的啮齿类传病媒介都不同，但包括小鼠、田鼠、鼩鼱和大鼠。人与人之间传播已在安第斯病毒感染中有过报道[15]。

          

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Literature review current through: 2017-06 . | This topic last updated: 2016-05-04.
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