人感染禽流感病毒H7N9的流行和防治：證據、挑戰與思考_《中國循證醫學雜志》

作者：

李向蓮 ,  李幼平

四川大學華西醫院中國循證醫學中心（成都 610041）;

關鍵詞：

H7N9 人感染禽流感病毒流行防治證據

DOI：

10.7507/1672-2531.20130139

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

2013年2月我國安徽省和上海市報道了3例全球首發人感染新型H7N9禽流感病毒病例，隨后疫情迅速波及到臨近的浙江、江蘇等省。截至2013年5月30日，WHO已報告發病132例，死亡37例，病死率28%。本文針對此次重大突發疫情，基于數據和證據，回顧性分析其病原學、流行病學、臨床特點、治療和防控證據現狀。對這種新發種間傳播疾病爆發流行的風險監控和管理，我國乃至全球尚缺乏經驗和證據。準確快速發現禽流感病毒變異和傳播規律及速度成為防控、治療的關鍵。依靠全球當前可得的最佳綜合性證據，中西醫并重，中西藥并用，做到循證決策，才能有效防控疫情、治療患者、減少損失。

引用本文： 李向蓮,李幼平. 人感染禽流感病毒H7N9的流行和防治：證據、挑戰與思考. 中國循證醫學雜志, 2013, 13(7): 780-784. doi: 10.7507/1672-2531.20130139 復制

1.	Gao RB, Cao B, Hu YW, et al. Human infection with a novel avian-origin influenza A (H7N9) virus. N Engl J Med, 2013, 368 (20): 1888-1897.
2.	Li Q, Zhou L, Zhou MH, et al. Preliminary Report: Epidemiology of the Avian Influenza A (H7N9) Outbreak in China. N Engl J Med, 2013 Apr 24. [Epub ahead of print]. DOI: 10.1056/ NEJMoa1304617.
3.	WHO. Number of confirmed human cases of avian influenza A (H7N9) reported to WHO. 2013.05.30. Available from: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/Data_Reports/en/index.html.
4.	Chen Y, Liang WF, Yang SG, et al. Human infections with the emerging avian influenza A H7N9 virus from wet market poultry: clinical analysis and characterisation of viral genome. Lancet, 2013, 381(9881): 1916-1925.
5.	Xiong CL, Zhang ZJ, Jiang QW, et al. Evolutionary Characteristics of A/Hangzhou/1/2013 and Source of Avian Influenza Virus H7N9 Subtype in China. Clin Infect Dis, 2013 May 23.[Epub ahead of print]. DOI: 10.1093/cid/cit29 4.
6.	Liu D, Shi WF, Shi Y, et al. Origin and diversity of novel avian influenza A H7N9 viruses causing human infection: phylogenetic, structural, and coalescent analyses. Lancet, 2013, 381(9881): 1926-1932.
7.	Zhu H, Wang D, Kelvin DJ, et al. Infectivity, Transmission, and Pathology of Human H7N9 Influenza in Ferrets and Pigs. Science, 2013 Jun 21. [Epub ahead of print]. DOI:10.1126/science.1239844.
8.	Gao HN, Lu HZ, Cao B, et al. Clinical Findings in 111 Cases of Influenza A (H7N9) Virus Infection. N Engl J Med, 2013, 368(24): 2277-2285.
9.	Skowronski DN, Janjua N, Kwindt T, et al. Virus-host interactions and the unusual age and sex distribution of human cases of influenza A(H7N9) in China, April 2013. Euro Surveill, 2013, 18(17): 20465.
10.	WHO. Cumulative number of confirmed human cases of avian influenza A (H5N1) reported to WHO. 2013.04.26. Avaliable from: http://www.who.int/influenza/human_animal_interface/H5N1_cumulative_table_archives/en/index.html.
11.	陳觀升, 王桂林, 許世祿. 人禽流感研究現狀. 河南預防醫學雜志, 2009, 20(3): 229-232.
12.	Parry J. H7N9 virus is more transmissible and harder to detect than H5N1, say experts. BMJ, 2013, 346: f2568.
13.	中國疾病預防控制中心. 人感染 H7N9 禽流感診療方案 (2013年第2版). 2013.04.11. Available from: http://www.chinacdc.cn/jkzt/crb/rgrgzbxqlg_5295/rgrglgyh/201304/t20130411_79740.htm.
14.	Kuehn BM. CDC: Use antivirals early, aggressively for H7N9 flu. JAMA, 2013, 309(20): 2086.
15.	WHO. Clinical management of human infection with avian influenza A (H5N1) virus. 2007. 08.15. Available from: http://www.who.int/influenza/resources/documents/clinical_management_h5n1_15_08_2007/en/.
16.	中華中醫藥學會. 中醫藥防治人禽流感專家建議. 中華中醫藥學刊, 2007, 25(7): 1535-1536.
17.	中國衛生部. 人禽流感診療方案(2008版). 中國中醫藥現代遠程教育, 2009, 7(2): 1-6.
18.	Hu YW, Lu SH, Song ZG, et al. Association between adverse clinical outcome in human disease caused by novel influenza A H7N9 virus and sustained viral shedding and emergence of antiviral resistance. The Lancet, 2013, 381(9885): 2273-2279.
19.	首個H5N1型禽流感人用疫苗問世. 亞太傳統醫學, 2007, 4:90.
20.	中國衛生計生委.《人感染 H7N9 禽流感疫情防控方案》. 2013.05.13. Available from: http://www.chinacdc.cn/mtdx/crbxx/201305/t20130513_80912.htm.
21.	中國衛生計生委.《人感染 H7N9 禽流感醫院感染預防與控制技術指南》.2013.04.04. Available from: http://www.chinacdc.cn/jkzt/crb/rgrgzbxqlg_5295/rgrglgyh/201304/t20130404_79474.htm.
22.	WHO. Interim WHO surveillance recommendations for human infection with avian influenza A (H7N9) virus. 2013.05.10. Available from: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/InterimSurveillanceRecH7N9_10May13.pdf.

1. Gao RB, Cao B, Hu YW, et al. Human infection with a novel avian-origin influenza A (H7N9) virus. N Engl J Med, 2013, 368 (20): 1888-1897.
2. Li Q, Zhou L, Zhou MH, et al. Preliminary Report: Epidemiology of the Avian Influenza A (H7N9) Outbreak in China. N Engl J Med, 2013 Apr 24. [Epub ahead of print]. DOI: 10.1056/ NEJMoa1304617.
3. WHO. Number of confirmed human cases of avian influenza A (H7N9) reported to WHO. 2013.05.30. Available from: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/Data_Reports/en/index.html.
4. Chen Y, Liang WF, Yang SG, et al. Human infections with the emerging avian influenza A H7N9 virus from wet market poultry: clinical analysis and characterisation of viral genome. Lancet, 2013, 381(9881): 1916-1925.
5. Xiong CL, Zhang ZJ, Jiang QW, et al. Evolutionary Characteristics of A/Hangzhou/1/2013 and Source of Avian Influenza Virus H7N9 Subtype in China. Clin Infect Dis, 2013 May 23.[Epub ahead of print]. DOI: 10.1093/cid/cit29 4.
6. Liu D, Shi WF, Shi Y, et al. Origin and diversity of novel avian influenza A H7N9 viruses causing human infection: phylogenetic, structural, and coalescent analyses. Lancet, 2013, 381(9881): 1926-1932.
7. Zhu H, Wang D, Kelvin DJ, et al. Infectivity, Transmission, and Pathology of Human H7N9 Influenza in Ferrets and Pigs. Science, 2013 Jun 21. [Epub ahead of print]. DOI:10.1126/science.1239844.
8. Gao HN, Lu HZ, Cao B, et al. Clinical Findings in 111 Cases of Influenza A (H7N9) Virus Infection. N Engl J Med, 2013, 368(24): 2277-2285.
9. Skowronski DN, Janjua N, Kwindt T, et al. Virus-host interactions and the unusual age and sex distribution of human cases of influenza A(H7N9) in China, April 2013. Euro Surveill, 2013, 18(17): 20465.
10. WHO. Cumulative number of confirmed human cases of avian influenza A (H5N1) reported to WHO. 2013.04.26. Avaliable from: http://www.who.int/influenza/human_animal_interface/H5N1_cumulative_table_archives/en/index.html.
11. 陳觀升, 王桂林, 許世祿. 人禽流感研究現狀. 河南預防醫學雜志, 2009, 20(3): 229-232.
12. Parry J. H7N9 virus is more transmissible and harder to detect than H5N1, say experts. BMJ, 2013, 346: f2568.
13. 中國疾病預防控制中心. 人感染 H7N9 禽流感診療方案 (2013年第2版). 2013.04.11. Available from: http://www.chinacdc.cn/jkzt/crb/rgrgzbxqlg_5295/rgrglgyh/201304/t20130411_79740.htm.
14. Kuehn BM. CDC: Use antivirals early, aggressively for H7N9 flu. JAMA, 2013, 309(20): 2086.
15. WHO. Clinical management of human infection with avian influenza A (H5N1) virus. 2007. 08.15. Available from: http://www.who.int/influenza/resources/documents/clinical_management_h5n1_15_08_2007/en/.
16. 中華中醫藥學會. 中醫藥防治人禽流感專家建議. 中華中醫藥學刊, 2007, 25(7): 1535-1536.
17. 中國衛生部. 人禽流感診療方案(2008版). 中國中醫藥現代遠程教育, 2009, 7(2): 1-6.
18. Hu YW, Lu SH, Song ZG, et al. Association between adverse clinical outcome in human disease caused by novel influenza A H7N9 virus and sustained viral shedding and emergence of antiviral resistance. The Lancet, 2013, 381(9885): 2273-2279.
19. 首個H5N1型禽流感人用疫苗問世. 亞太傳統醫學, 2007, 4:90.
20. 中國衛生計生委.《人感染 H7N9 禽流感疫情防控方案》. 2013.05.13. Available from: http://www.chinacdc.cn/mtdx/crbxx/201305/t20130513_80912.htm.
21. 中國衛生計生委.《人感染 H7N9 禽流感醫院感染預防與控制技術指南》.2013.04.04. Available from: http://www.chinacdc.cn/jkzt/crb/rgrgzbxqlg_5295/rgrglgyh/201304/t20130404_79474.htm.
22. WHO. Interim WHO surveillance recommendations for human infection with avian influenza A (H7N9) virus. 2013.05.10. Available from: http://www.who.int/influenza/human_animal_interface/influenza_h7n9/InterimSurveillanceRecH7N9_10May13.pdf.

《中國循證醫學雜志》

人感染禽流感病毒H7N9的流行和防治：證據、挑戰與思考

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

《中國循證醫學雜志》

人感染禽流感病毒H7N9的流行和防治：證據、挑戰與思考

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料