由香港大学李嘉诚医学院微生物学系系主任霍英东基金教授（传染病学）袁国勇教授和内科学系临床助理教授孔繁毅医生领导的研究小组发现，恢复期血浆治疗成功降低严重猪流感患者死亡率达50%。这个研究结果将刊登于《临床传染病期刊》(Clinical Infectious Diseases)。

2009年4月至12月期间，香港有超过三万名病人确诊患上人类猪型流感（下称猪流感，即2009年H1N1流感大流行）。当中1%的猪流感病人有严重感染，需要住院治疗及接受呼吸协助，85名患者最后更死于这种新型病毒感染。虽然香港卫生署在2009年发起了针对高风险人士的大型人类猪流感疫苗注射计划，可是由于其中一位接种者出现罕见的吉巴氏综合症，并遭广泛报道，以致疫苗接种率偏低。此外，有相当大比例的严重个案是年轻健康患者，他们并非高风险人士，因此不属疫苗接种计划的目标组别。这些严重案例有许多是因为在发病后48小时以后才接受治疗，以致抗病毒药物如特敏福等失去效用。

为了治疗这些严重案例，特别是那些年轻感染者，小组根据西班牙型流感患者的恢复期血浆治疗经验，进行了一项前瞻性研究。小组以由香港红十字会招募的猪流感康复者捐赠的恢复期血浆，对这些严重案例作治疗。病人分为两组，其中20个病人接受恢复期血浆，而另外73个病人则没有接受血浆治疗。结果显示治疗组死亡率明显低于非治疗组（20.0% 比 54.8%; P<0.01）。研究并发现血浆治疗显着降低第3至7天的呼吸道病毒数目和细胞因子反应。

这项研究显示了恢复期血浆对于治疗感染严重猪流感是非常有效和重要。此治疗有效地降低病毒数目和细胞因子反应，从而显着地降低死亡率。它也克服了抗药性病毒和延误治疗的问题。研究小组相信有必要进行一个双盲随机对照的临床高免疫球蛋白研究以进一步探讨有关方法的疗效。（生物谷Bioon.com）

生物谷推荐原文出处：

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.