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中山大学附属第三医院内科ICU//呼吸与危重症医学科,广东 广州 510630
Received:28 August 2025,
Revised:2025-09-07,
Accepted:09 September 2025,
Published:20 September 2025
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石云锋,吴本权.基孔肯雅热:识别、治疗与防控[J].中山大学学报(医学科学版),2025,46(05):730-736.
SHI Yunfeng,WU Benquan.Chikungunya Fever: Recognition, Treatment, Prevention and Control[J].Journal of Sun Yat-sen University(Medical Sciences),2025,46(05):730-736.
石云锋,吴本权.基孔肯雅热:识别、治疗与防控[J].中山大学学报(医学科学版),2025,46(05):730-736. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2025.0502.
SHI Yunfeng,WU Benquan.Chikungunya Fever: Recognition, Treatment, Prevention and Control[J].Journal of Sun Yat-sen University(Medical Sciences),2025,46(05):730-736. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2025.0502.
基孔肯雅热(CHIKF)是由基孔肯雅病毒(CHIKV)感染引起、经伊蚊媒介传播的急性病毒性传染病。轻症病例以发热、严重关节痛和皮疹为主要特征,多数预后良好,但有部分病例出现非典型表现与慢性并发症,高危人群有转为重症病例的风险。近年来,CHIKF在全球流行范围不断扩大,已成为重要的国际公共卫生问题。本文概述了CHIKF的基础知识,重点综述了诊断、鉴别诊断、病情评估、治疗及防控的进展。对于发病前12 d内有CHIKF流行区旅居史、发热、关节疼痛、皮疹等临床表现,结合急性期IgM抗体、特异性IgG抗体、急性期病毒分离、急性期病毒核酸等实验室检测可帮助诊断。同时应与登革病毒、寨卡病毒等相似病毒引发的疾病进行鉴别或排除。在治疗方面,目前尚无特效抗病毒药物,以对症支持治疗为主,可使用非甾体抗炎药缓解发热和疼痛。在防控方面的核心策略是切断传播途径,积极消灭蚊虫。CHIKF未来研究应继续致力于开发特效药物、安全有效的疫苗以及更便捷、准确的诊断工具,以应对该病持续扩散带来的挑战。
Chikungunya fever (CHIKF) is a mosquito-borne infectious disease caused by Chikungunya virus (CHIKV) infection. The acute phase of CHIKF is mainly characterized by fever, severe polyarthralgia, and rash. Most cases are self-limited, however, atypical manifestations and chronic complications also occur in a minor proportion of cases. High-risk cases are at risk of complicating with severe condition. For these years, the emergence and spread of CHIKF place it as an international public health disease. This article summarizes the current knowledge and advances about CHIKF, with a focus on the diagnosis, differential diagnosis, evaluation, treatment, prevention and control. For individuals with a history of traveling to CHIKF prevalence areas within 12 days, presenting with fever, arthralgia, and rash, combined with laboratory tests such as positive IgM antibody, specific IgG antibody, CHIKV isolation, or viral nucleic acid testing in acute stage, could establish the diagnosis. Differential diagnosis with infection caused by similar viruses such as dengue virus and Zika virus should be considered too. Regarding treatment, there is no specific antiviral drug available currently. Supportive method is the dominating treatment, with non-steroidal anti-inflammatory drugs used to alleviate fever and arthralgia. The core strategy in prevention and control of CHIKF is to interrupt the transmission and eliminate mosquitoes. To meet challenges posed by the spread of CHIKF, the future researches should emphasize on developing specific antiviral drugs, safe and effective vaccines, and convenient and accurate diagnostic means.
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