由香港大學(xué)李嘉誠(chéng)醫(yī)學(xué)院微生物學(xué)系系主任霍英東基金教授（傳染病學(xué)）袁國(guó)勇教授和內(nèi)科學(xué)系臨床助理教授孔繁毅醫(yī)生領(lǐng)導(dǎo)的研究小組發(fā)現(xiàn)，恢復(fù)期血漿治療成功降低嚴(yán)重豬流感患者死亡率達(dá)50%,。這個(gè)研究結(jié)果將刊登于《臨床傳染病期刊》(Clinical Infectious Diseases),。
2009年4月至12月期間，香港有超過(guò)三萬(wàn)名病人確診患上人類(lèi)豬型流感（下稱(chēng)豬流感,，即2009年H1N1流感大流行）,。當(dāng)中1%的豬流感病人有嚴(yán)重感染，需要住院治療及接受呼吸協(xié)助,，85名患者最后更死于這種新型病毒感染,。雖然香港衛(wèi)生署在2009年發(fā)起了針對(duì)高風(fēng)險(xiǎn)人士的大型人類(lèi)豬流感疫苗注射計(jì)劃，可是由于其中一位接種者出現(xiàn)罕見(jiàn)的吉巴氏綜合癥,，并遭廣泛報(bào)道,，以致疫苗接種率偏低。此外,，有相當(dāng)大比例的嚴(yán)重個(gè)案是年輕健康患者,，他們并非高風(fēng)險(xiǎn)人士,，因此不屬疫苗接種計(jì)劃的目標(biāo)組別,。這些嚴(yán)重案例有許多是因?yàn)樵诎l(fā)病后48小時(shí)以后才接受治療，以致抗病毒藥物如特敏福等失去效用,。
為了治療這些嚴(yán)重案例,，特別是那些年輕感染者，小組根據(jù)西班牙型流感患者的恢復(fù)期血漿治療經(jīng)驗(yàn),，進(jìn)行了一項(xiàng)前瞻性研究,。小組以由香港紅十字會(huì)招募的豬流感康復(fù)者捐贈(zèng)的恢復(fù)期血漿，對(duì)這些嚴(yán)重案例作治療,。病人分為兩組,，其中20個(gè)病人接受恢復(fù)期血漿，而另外73個(gè)病人則沒(méi)有接受血漿治療,。結(jié)果顯示治療組死亡率明顯低于非治療組（20.0% 比 54.8%; P<0.01）,。研究并發(fā)現(xiàn)血漿治療顯著降低第3至7天的呼吸道病毒數(shù)目和細(xì)胞因子反應(yīng)。
這項(xiàng)研究顯示了恢復(fù)期血漿對(duì)于治療感染嚴(yán)重豬流感是非常有效和重要,。此治療有效地降低病毒數(shù)目和細(xì)胞因子反應(yīng),，從而顯著地降低死亡率。它也克服了抗藥性病毒和延誤治療的問(wèn)題,。研究小組相信有必要進(jìn)行一個(gè)雙盲隨機(jī)對(duì)照的臨床高免疫球蛋白研究以進(jìn)一步探討有關(guān)方法的療效,。（生物谷Bioon.com）
生物谷推薦原文出處：
Clinical Infectious Diseases 2011;52(4):510–519
Convalescent Plasma Treatment Reduced Mortality in Patients With Severe Pandemic Influenza A (H1N1) 2009 Virus Infection
Ivan FN Hung,1,2 Kelvin KW To,1 Cheuk-Kwong Lee,3 Kar-Lung Lee,4 Kenny Chan,5 Wing-Wah Yan,5 Raymond Liu,6 Chi-LeungWatt,7 Wai-Ming Chan,8 Kang-Yiu Lai,9 Chi-Kwan Koo,10 Tom Buckley,11 Fu-Loi Chow,12 Kwan-KeungWong,13 Hok-Sum Chan,14 Chi-Keung Ching,15 Bone SF Tang,16 Candy CY Lau,1 Iris WS Li,1 Shao-Haei Liu,17 Kwok-Hung Chan,1 Che-Kit Lin,3 and Kwok-Yung Yuen1
Background.
Experience from treating patients with Spanish influenza and influenza A(H5N1) suggested that convalescent plasma therapy might be beneficial. However, its efficacy in patients with severe pandemic influenza A(H1N1) 2009 virus (H1N1 2009) infection remained unknown.
Methods.
During the period from 1 September 2009 through 30 June 2010, we conducted a prospective cohort study by recruiting patients aged >18 years with severe H1N1 2009 infection requiring intensive care. Patients were offered treatment with convalescent plasma with a neutralizing antibody titer of >1:160, harvested by apheresis from patients recovering from H1N1 2009 infection. Clinical outcome was compared with that of patients who declined plasma treatment as the untreated controls.
Results.
Ninety-three patients with severe H1N1 2009 infection requiring intensive care were recruited. Twenty patients (21.5%) received plasma treatment. The treatment and control groups were matched by age, sex, and disease severity scores. Mortality in the treatment group was significantly lower than in the nontreatment group (20.0% vs 54.8%; P 5 .01). Multivariate analysis showed that plasma treatment reduced mortality (odds ratio [OR], .20; 95% confidence interval [CI], .06-.69; P 5 .011), whereas complication of acute renal failure was independently associated with death (OR, 3.79; 95% CI, 1.15-12.4; P 5 .028). Subgroup analysis of 44 patients with serial respiratory tract viral load and cytokine level demonstrated that plasma treatment was associated with significantly lower day 3, 5, and 7 viral load, compared with the control group (P , .05). The corresponding temporal levels of interleukin 6, interleukin 10, and tumor necrosis factor a (P , .05) were also lower in the treatment group.
Conclusions.
Treatment of severe H1N1 2009 infection with convalescent plasma reduced respiratory tract viral load, serum cytokine response, and mortality.
