恙虫病致病机制及辅助检查研究进展

doi:10.3969/j.issn.1006-5725.2019.16.034

实用医学杂志 ›› 2019, Vol. 35 ›› Issue (16): 2669-2672.doi: 10.3969/j.issn.1006-5725.2019.16.034

恙虫病致病机制及辅助检查研究进展

李柏成^1,2, 张剑锋²

广西医科大学 1研究生院, 2第二附属医院急诊科（南宁 530021）

收稿日期:2019-02-12 出版日期:2019-08-27 发布日期:2019-08-27
通讯作者: 张剑锋 E-mail： zhangjianfeng930@163.com
基金资助:
2017广西重点研发计划项目（编号：桂科AB17195002）

Progress in pathogenesis and diagnosis of scrub typhus

LI Baicheng^*, ZHANG Jianfeng

*Graduate School, Guangxi Medical University, Nanning 530021, China

Received:2019-02-12 Online:2019-08-27 Published:2019-08-27
Contact: ZHANG Jianfeng E-mail： zhangjianfeng930@163.com

摘要/Abstract

摘要： 恙虫病是一种全身性疾病,感染人体后可以引发局部或全身炎症反应,导致单个或多个组织、器官、系统发生血管炎性改变。临床上可表现为发热、焦痂等症状或出现肺、肝、肾、心脏、消化道等损害改变,甚至发生呼吸循环衰竭、多器官功能障碍、消化道出血、脑炎、嗜血细胞综合征等危及生命的并发症。目前关于恙虫病发病机制尚无定论,本文就恙虫病的免疫机制及辅助检查特点进行综述,旨在加深对该疾病的认识和诊断。

关键词: 恙虫病, 致病机制, 辅助检查, 综述

Abstract: Scrub typhus is a systemic disease that can cause local or systemic inflammatory responses to the body, can cause inflammatory changes in the blood vessels of single or multiple tissues and organs. It can be manifested as fever, eschar, pneumonia, liver and kidney damage, shock, blood, nervous system changes, and even respiratory and circulatory failure, multi-organ dysfunction, gastrointestinal bleeding, encephalitis, hemophilous cell syndrome and other life-threatening complications. Now, there is no consensus on the pathogenesis of scrub typhus. Therefore, this article reviews the immune mechanism and the diagnostic point of scrub typhus, aiming at deepening the understanding and diagnosis of the disease.

Key words: scrub typhus, pathogenesis, diagnostic examination, review

李柏成, 张剑锋. 恙虫病致病机制及辅助检查研究进展[J]. 实用医学杂志, 2019, 35(16): 2669-2672.

LI Baicheng, ZHANG Jianfeng. Progress in pathogenesis and diagnosis of scrub typhus[J]. The Journal of Practical Medicine, 2019, 35(16): 2669-2672.

参考文献 37

[1]	冯时,梁张,赵桂萍,等. 恙虫病的免疫机制研究进展[J]. 生命科学研究,2016,20(3):267-270.
[2]	KINGSTON H W, HOSSAIN M, LEOPOLD S, et al.Rickettsial illnesses as important causes of febrile illness in Chittagong, Bangladesh[J]. Emerg Infect Dis, 2018,24(4):638-645.
[3]	谭雪梅,刘园园,雷旭,等. 恙虫病基础和临床诊治研究进展[J]. 中华实验和临床感染病杂志(电子版),2017,11(5):437-440.
[4]	EVANS S M, RODINO K G, ADCOX H E.Orientia tsutsugamushi uses two Ank effectors to modulate NF-κB p65 nuclear transport and inhibit NF-κB transcriptional activation[J]. PLoS Pathog,2018,14(5):e1007023.
[5]	SOONG L, SHELITE T R, XING Y, et al.Type 1-skewed neuroinflammation and vascular damage associated with orientia tsutsugamushi infection in mice[J]. PLoS Negl Trop Dis, 2017,11(7):e0005765.
[6]	SHELITE T R, LIANG Y, WANG H, et al.IL-33-dependent endothelial activation contributes to apoptosis and renal injury in orientia tsutsugamushi-infected mice[J]. PLoS Negl Trop Dis, 2016, 10(3):e0004467.
[7]	YOUNG S K, JI H Y, SEUNG Y S, et al.Chemokine and cytokine production during orientia tsutsugamushi infection in mice[J]. Microb Pathog,2004,36(1):51-57.
[8]	KELLER C A, HAUPTMANN M, KOLBAUM J, et al.Dissemination of orientia tsutsugamushi and inflammatory responses in a murine model of scrub typhus[J]. PLoS Negl Trop Dis,2014,8(8):e3064.
[9]	OTTERDAL K, JANARDHANAN J, ASTRUP E,et al.Increased endothelial and macrophage markers are associated with disease severity and mortality in scrub typhus[J]. J Infect,2014,69(5):462-469.
[10]	MI J K, MEE K K, JAE S K.Orientia tsutsugamushi inhibits tumor necrosis factor α production by inducing interleukin 10 secretion in murine macrophages[J]. Microb Pathog,2006,40(1):1-7.
[11]	KANG S J, JIN H M, CHO Y N, et al.Dysfunction of circulating natural killer T cells in patients with scrub typhus[J]. J Infect Dis, 2018,218(11):1813-1821.
[12]	KANG S J, JIN HM, CHO Y N, et al.Increased level and interferon-γ production of circulating natural killer cells in patients with scrub typhus[J]. PLoS Negl Trop Dis,2017,11(7):e0005815.
[16]	KANG S J, JIN H M, WON E J, et al.Activation,impaired tumor necrosis factor-α production, and deficiency of circulating mucosal-associated invariant T cells in patients with scrub typhus[J]. PLoS Negl Trop Dis,2016,10(7):e0004832.
[14]	HAUPTMANN M,KOLBAUM J,LILLA S,et al.Protective and pathogenic roles of CD8+ T lymphocytes in murine orientia tsutsugamushi infection[J]. PLoS Negl Trop Dis,2016,10(9):e0004991.
[15]	XU G, MENDLL N L, LIANG Y, et al.CD8+ T cells provide immune protection against murine disseminated endotheliotropic orientia tsutsugamushi infection[J]. PLoS Negl Trop Dis, 2017,11(7):e0005763.
[16]	HA N Y, SHARMA P, KIM G, et al.Immunization with an autotransporter protein of orientia tsutsugamushi provides protective immunity against scrub typhus[J]. PLoS Negl Trop Dis,2015,9(3):e0003585.
[17]	RODKVAMTOOK W, ZHANG Z, CHAO C C, et al.Dot-ELISA rapid test using recombinant 56-kDa protein antigensfor serodiagnosis of scrub typhus[J]. Am J Trop Med Hyg,2015,92(5):967-971.
[18]	ASTRUP E, JANARDHANAN J, OTTERDAL K, et al.Cytokine network in scrub typhus:high levels of interleukin-8 are associated with disease severity and mortality[J]. PLoS Negl Trop Dis,2014,8(2):e2648.
[19]	DITTRICH S,SUNYAKUMTHORN P,RATTANAVONG S,et al.Blood-brain barrier function and biomarkers of central nervous system injury in rickettsial versus other neurological infections in laos[J]. Am J Trop Med Hyg,2015,93(2):232-237.
[20]	王丹枫,林元耀,吕继算,等. 恙虫病合并多脏器损害82例分析[J]. 实用医学杂志,2001, 17(4):352-353.
[21]	KUMAR V,KUMAR V,YADAV A K,et al.Scrub typhus is an under-recognized cause of acute febrile illness with acute kidney injury in India[J]. PLoS Negl Trop Dis,2014,8(1):e2605.
[22]	王瑞丽,戴威,程碧环,等. 恙虫病的临床特征及重症恙虫病的早期诊断[J]. 温州医科大学学报,2017,47(11):832-835.
[23]	张自优. 61例恙虫病患者临床及血液学特征分析[D]. 大理学院,2014.
[24]	邹光美,黄朝任,周传林,等. 恙虫病合并多器官功能障碍综合征的实验室检查相关危险因素分析[J]. 中国卫生检验杂志,2018,28(6):745-749.
[25]	ARONOFF D M,WATT G.Prevalence of relative bradycardia in orientia tsutsugamushi infection[J]. Am J Trop Med Hyg,2003,68(4):477-479.
[26]	陈邦银,黄津. 恙虫病合并中毒性肝炎70例临床观察[J]. 中国现代医药杂志,2016,18(4):24-26.
[27]	李久荣,刘群,陈春成,等. 恙虫病严重程度与血清降钙素原水平的相关性[J]. 中国医学科学院学报,2018,40(3):334-337.
[28]	蔡杰,李琼,曹堃,等. 血清降钙素原动态检出值的变化对早期诊断恙虫病患者的临床意义及其防治对策[J]. 抗感染药学,2018,15(3):463-465.
[29]	李俊岭,邓涛,吴汉聪. 降钙素原清除率对严重脓毒症预后的预测价值[J]. 实用医学杂志,2017,33(2):262-264.
[30]	刘洋. PCT、D-D联合检测在恙虫病诊疗中的意义[J]. 中国继续医学教育,2017,9(30):84-86.
[31]	李璐,张敏,徐玉辉,等. 重症恙虫病的临床特征分析[J]. 中国全科医学,2015,18(23):2813-2816.
[32]	YEN T H,CHANG C T,LIN J L,et al.Scrub typhus: a frequently overlooked cause of acute renal failure[J]. Ren Fail,2003,25(3):397-410.
[33]	谭雪梅,刘园园,雷旭,等. 恙虫病基础和临床诊治研究进展[J]. 中华实验和临床感染病杂志(电子版),2017,11(5):437-440.
[34]	BISWAL M,ZAMMAN K,SURI V,et al.Use of eschar for the molecular diagnosis and genotypic characterisation of causing scrub typhus[J]. Indian J Med Microbiol, 2018, 36(3):422-425.
[35]	PHUKLIA W,PANYANIVONG P,SENGDETKA D,et al.Novel high-throughput screening method using quantitative PCR to determine the antimicrobial susceptibility of orientia tsutsugamushi clinical isolates[J]. J Antimicrob Chemother, 2019, 74(1):74-81.
[36]	陶霞,张晶,魏跃红,等. 2012-2016年广州市人感染恙虫病东方体基因型与流行病学特征分析[J]. 疾病监测,2018,33(11):902-907.
[37]	DAAZ F E,ABARCA K,KALERGIS A M.An update on host-pathogen interplay and modulation of immune responses during orientia tsutsugamushi infection[J]. Clin Microbiol Rev,2018,31(2):e00076-17.

恙虫病致病机制及辅助检查研究进展

Progress in pathogenesis and diagnosis of scrub typhus

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献 37

相关文章 0

编辑推荐

Metrics

本文评价