可疑感染因素引起的慢性疲劳综合征病例的流行病学调查
发布时间：2018-09-09 09:38
【摘要】：从2009年6月开始,国家卫生部门连续接到了很多“患者”的反映,他们认为自己已经感染了HIV,并在不安全性行为后出现很多类似艾滋病的相关症状。卫生部对“患者”的诉求高度重视,并组织相关的部门对他们展开咨询和调查。近年来一些研究机构和团队也积极参与研究。但是,该群体的主诉症状与常规临床检测结果有明显背离的倾向使这一问题复杂化。心理学说与病原体感染学说成为相关研究者争论的焦点。我们在前期的观察显示,该人群显示出的群体化特征包括:严重疲劳,全身/局部肌肉关节疼痛、低热盗汗、淋巴节肿大、咽喉炎、牙龈萎缩、舌苔白腻、皮疹等。结合系统分析的结果,其症状特点与病原体感染引发的CFS相似。因此在本课题中我们拟采用流行病学调查方法进一步观察、描述这一“疾病”特点,为深入验证这一假设提供依据。研究结果如下:1.以2000至2014年间发表于Web of Science数据库的CFS相关文献为研究对象,利用可视化软件CiteSpaceⅢ,绘制与CFS相关的科学知识图谱。分析发现国际上围绕CFS领域的研究和探索已经取得重要进展。其中美、英等发达国家的科学团队贡献最多。现况研究、CFS症状与机体神经系统功能的关联、心理干预、病因探索、认知治疗对CFS的疗效研究等,成为了CFS领域的主要研究方向。2.CFS领域近些年的研究前沿主要为病原体感染的病因学说。能引发CFS的病原体涉及支原体,EB病毒,肠道病毒,伯纳特氏立克次体,人类疱疹病毒,肠道革兰阴性杆菌等,感染后呈现典型的CFS慢性症状。3.通过对425例与感染有关的CFS患者进行调查发现,其中以男性为主(86.12%),可疑暴露途径以不安全性行为(商业性行为、网络一夜情)为主(285例,67.06%),该群体的CFS主诉症状有严重疲劳,头痛,肌肉痛,关节痛,淋巴节肿大等,涉及皮肤、呼吸道、消化道、骨骼肌肉和神经系统等。相关症状与国内外报道的由感染引发的CFS症状高度重叠。部分病例提交了临床检测分析报告单,其中CD4/CD8比例异常139例(62.61%),与感染/炎症相关的白细胞/中性粒细胞/淋巴细胞/单核细胞指标异常120例(46.15%)。这些结果与我们的推论(因不安全性行为导致病原体感染,导致CFS症状出现)一致。4.45名CFS患者的现场调查显示,其个体特征、临床特点、可疑感染暴露途径与网络调查结果一致。其中CD4/CD8比值异常15例(33.33%),PPD阳性(++~+++)16例(35.56%)。与正常人群相比,CFS病例组的血清IgM、IgA、CRP的平均水平显著增高。证明被观察人群中存在感染及炎性反应的生物学特点,进一步验证了研究推论。5.通过对纳入CFS患者的32个家庭,51名家属(父母,配偶,子女,兄妹)进行家庭调查发现,有25名家属(49.02%)被诊断为CFS,此外,还有6名家属(11.76%)被诊断为慢性疲劳状态。这些结果显示,由感染引发的CFS病例可能存在家庭聚集现象。
[Abstract]:Since June 2009, the national health sector has received a number of "patients" who believe they have contracted HIV, and developed AIDS-related symptoms after unsafe sex. The Ministry of Health attaches great importance to patients' demands, and organizes relevant departments to conduct counseling and investigation on them. In recent years, a number of research institutions and teams have been actively involved in research. However, the main symptoms of the group tend to deviate from the results of routine clinical tests, which complicates the problem. Psychology theory and pathogen infection theory have become the focus of debate. Our previous observations show that the group features of this population include: severe fatigue, systemic / local muscle joint pain, low fever night sweating, lymphoid ganglion enlargement, pharyngitis, gingival atrophy, tongue coating white greasy, rash and so on. Combined with the results of systematic analysis, the symptoms were similar to those of CFS caused by pathogen infection. Therefore, we intend to use epidemiological investigation method to further observe and describe the characteristics of this "disease" in order to provide a basis for further verification of this hypothesis. The results are as follows: 1. Based on the literature related to CFS published in Web of Science database from 2000 to 2014, the scientific knowledge map related to CFS was drawn by using the visualization software CiteSpace 鈪，
本文编号：2232005
[Abstract]:Since June 2009, the national health sector has received a number of "patients" who believe they have contracted HIV, and developed AIDS-related symptoms after unsafe sex. The Ministry of Health attaches great importance to patients' demands, and organizes relevant departments to conduct counseling and investigation on them. In recent years, a number of research institutions and teams have been actively involved in research. However, the main symptoms of the group tend to deviate from the results of routine clinical tests, which complicates the problem. Psychology theory and pathogen infection theory have become the focus of debate. Our previous observations show that the group features of this population include: severe fatigue, systemic / local muscle joint pain, low fever night sweating, lymphoid ganglion enlargement, pharyngitis, gingival atrophy, tongue coating white greasy, rash and so on. Combined with the results of systematic analysis, the symptoms were similar to those of CFS caused by pathogen infection. Therefore, we intend to use epidemiological investigation method to further observe and describe the characteristics of this "disease" in order to provide a basis for further verification of this hypothesis. The results are as follows: 1. Based on the literature related to CFS published in Web of Science database from 2000 to 2014, the scientific knowledge map related to CFS was drawn by using the visualization software CiteSpace 鈪，
本文编号：2232005
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