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stringlengths 4
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|---|---|
HV间期受自主神经影响较小，故在同一次检查中数值比较恒定。
|
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"id": 0,
"entity": "自主神经",
"start_offset": 5,
"end_offset": 9,
"label": "bod"
}
] |
（五）临床心电生理检查方法临床心电生理检查的基本方法是与体表导联心电图同步的经静脉和（或）经动脉的心腔内电图记录技术与心腔内刺激（起搏）技术心腔）技术相结合。
|
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"id": 0,
"entity": "临床心电生理检查",
"start_offset": 3,
"end_offset": 11,
"label": "pro"
},
{
"id": 1,
"entity": "临床心电生理检查",
"start_offset": 13,
"end_offset": 21,
"label": "pro"
},
{
"id": 2,
"entity": "体表导联心电图",
"start_offset": 28,
"end_offset": 35,
"label": "pro"
},
{
"id": 3,
"entity": "心腔内刺激（起搏）技术",
"start_offset": 59,
"end_offset": 70,
"label": "pro"
},
{
"id": 4,
"entity": "心腔",
"start_offset": 70,
"end_offset": 72,
"label": "bod"
}
] |
在心电生理检查前，应当停用各种心律失常药，以免药物改变心电生理特性和妨碍心律失常的诱发。
|
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"id": 0,
"entity": "心律失常",
"start_offset": 15,
"end_offset": 19,
"label": "dis"
},
{
"id": 1,
"entity": "心律失常",
"start_offset": 36,
"end_offset": 40,
"label": "dis"
}
] |
用经皮穿刺插入电极导管的技术，把为记录心腔内电图和心腔刺激（起搏）用的电极导管顶端放置于适当的心腔内部位，并将它们的尾部分别连接于生理记录仪和程序刺激仪。
|
[
{
"id": 0,
"entity": "心腔内电图",
"start_offset": 19,
"end_offset": 24,
"label": "pro"
},
{
"id": 1,
"entity": "心腔刺激",
"start_offset": 25,
"end_offset": 29,
"label": "pro"
},
{
"id": 2,
"entity": "心腔",
"start_offset": 47,
"end_offset": 49,
"label": "bod"
},
{
"id": 3,
"entity": "程序刺激仪",
"start_offset": 71,
"end_offset": 76,
"label": "equ"
}
] |
在窦性心律或起搏心律时，引进单个或多个程序的期前刺激是观察动态电生理学的方法。
|
[
{
"id": 0,
"entity": "窦性心律",
"start_offset": 1,
"end_offset": 5,
"label": "dis"
},
{
"id": 1,
"entity": "起搏心律",
"start_offset": 6,
"end_offset": 10,
"label": "dis"
}
] |
正常心脏以可预言的方式对这些干预作出反应。
|
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"entity": "心脏",
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了解并根据这些正常反应，程序刺激便可用来：1.刻划出房室传导系统、心房和心室的电生理特性。
|
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"entity": "房室",
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{
"id": 1,
"entity": "心房",
"start_offset": 33,
"end_offset": 35,
"label": "bod"
}
] |
2.诱发心律失常并分析其发生机制。
|
[
{
"id": 0,
"entity": "心律失常",
"start_offset": 4,
"end_offset": 8,
"label": "dis"
}
] |
3.评定药物、电刺激、导管消融和外科手术干预对房室传导系统、心房和心室功能的影响以及它们对心律失常的治疗效果。
|
[
{
"id": 0,
"entity": "电刺激",
"start_offset": 7,
"end_offset": 10,
"label": "pro"
},
{
"id": 1,
"entity": "导管消融",
"start_offset": 11,
"end_offset": 15,
"label": "pro"
},
{
"id": 2,
"entity": "外科手术",
"start_offset": 16,
"end_offset": 20,
"label": "pro"
},
{
"id": 3,
"entity": "房室传导系统",
"start_offset": 23,
"end_offset": 29,
"label": "bod"
},
{
"id": 4,
"entity": "心房",
"start_offset": 30,
"end_offset": 32,
"label": "bod"
},
{
"id": 5,
"entity": "心室",
"start_offset": 33,
"end_offset": 35,
"label": "bod"
},
{
"id": 6,
"entity": "心律失常",
"start_offset": 45,
"end_offset": 49,
"label": "dis"
}
] |
临床心电生理检查时，体表导联至少应有：Ⅰ、Ⅱ、V<sub>1</sub>或Ⅰ、aVF、V<sub>1</sub>。
|
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"id": 0,
"entity": "临床心电生理检查",
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"end_offset": 8,
"label": "pro"
}
] |
心腔内记录导联一般包括希氏束、高位右心房、冠状静脉窦及右心室心尖部。
|
[
{
"id": 0,
"entity": "心腔",
"start_offset": 0,
"end_offset": 2,
"label": "bod"
},
{
"id": 1,
"entity": "高位右心房",
"start_offset": 15,
"end_offset": 20,
"label": "bod"
},
{
"id": 2,
"entity": "冠状静脉窦",
"start_offset": 21,
"end_offset": 26,
"label": "bod"
},
{
"id": 3,
"entity": "右心室心尖部",
"start_offset": 27,
"end_offset": 33,
"label": "bod"
}
] |
心室（心房）标测有激动标测及起搏标测。
|
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{
"id": 0,
"entity": "心室",
"start_offset": 0,
"end_offset": 2,
"label": "bod"
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{
"id": 1,
"entity": "心房",
"start_offset": 3,
"end_offset": 5,
"label": "bod"
}
] |
（六）并发症心脏电生理检查的并发症主要包括三大类：1.与动、静脉穿刺插管有关疼痛、药物不良反应、穿刺部位的感染或脓疡、败血症、出血或血肿、血栓性静脉炎、肺血栓栓塞、动脉撕裂或夹层动脉瘤、全身性血栓栓塞、一过性缺血发作或中风。
|
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"id": 0,
"entity": "心脏电生理检查",
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{
"id": 1,
"entity": "动、静脉穿刺插管",
"start_offset": 28,
"end_offset": 36,
"label": "pro"
},
{
"id": 2,
"entity": "药物不良反应",
"start_offset": 41,
"end_offset": 47,
"label": "sym"
},
{
"id": 3,
"entity": "穿刺部位的感染或脓疡",
"start_offset": 48,
"end_offset": 58,
"label": "sym"
},
{
"id": 4,
"entity": "出血",
"start_offset": 63,
"end_offset": 65,
"label": "sym"
},
{
"id": 5,
"entity": "血肿",
"start_offset": 66,
"end_offset": 68,
"label": "sym"
},
{
"id": 6,
"entity": "肺血栓栓塞",
"start_offset": 76,
"end_offset": 81,
"label": "dis"
},
{
"id": 7,
"entity": "动脉撕裂",
"start_offset": 82,
"end_offset": 86,
"label": "dis"
},
{
"id": 8,
"entity": "全身性血栓栓塞",
"start_offset": 93,
"end_offset": 100,
"label": "dis"
},
{
"id": 9,
"entity": "中风",
"start_offset": 109,
"end_offset": 111,
"label": "dis"
}
] |
2.与心腔内导管操纵与程序刺激有关心腔或冠状窦穿孔、心包积血或心包填塞、房颤或室颤、心肌缺血或心肌梗死、束支传导阻滞。
|
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"id": 0,
"entity": "心腔内导管操纵",
"start_offset": 3,
"end_offset": 10,
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},
{
"id": 1,
"entity": "心包积血",
"start_offset": 26,
"end_offset": 30,
"label": "dis"
},
{
"id": 2,
"entity": "房颤",
"start_offset": 36,
"end_offset": 38,
"label": "dis"
},
{
"id": 3,
"entity": "室颤",
"start_offset": 39,
"end_offset": 41,
"label": "dis"
},
{
"id": 4,
"entity": "心肌缺血",
"start_offset": 42,
"end_offset": 46,
"label": "dis"
},
{
"id": 5,
"entity": "心肌梗死",
"start_offset": 47,
"end_offset": 51,
"label": "dis"
},
{
"id": 6,
"entity": "束支传导阻滞",
"start_offset": 52,
"end_offset": 58,
"label": "dis"
}
] |
3.与经导管消融有关完全性房室传导阻滞、瓣膜损伤或新出现的瓣膜关闭不全、急性冠状动脉血栓形成和慢性冠状动脉狭窄、心律失常、心腔、冠状窦或腔静脉穿孔、心包炎、心肌坏死、心力衰竭或心源性休克、肺静脉狭窄、膈神经麻痹等。
|
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{
"id": 0,
"entity": "经导管消融",
"start_offset": 3,
"end_offset": 8,
"label": "pro"
},
{
"id": 1,
"entity": "完全性房室传导阻滞",
"start_offset": 10,
"end_offset": 19,
"label": "dis"
},
{
"id": 2,
"entity": "瓣膜损伤",
"start_offset": 20,
"end_offset": 24,
"label": "dis"
},
{
"id": 3,
"entity": "新出现的瓣膜关闭不全",
"start_offset": 25,
"end_offset": 35,
"label": "dis"
},
{
"id": 4,
"entity": "急性冠状动脉血栓",
"start_offset": 36,
"end_offset": 44,
"label": "dis"
},
{
"id": 5,
"entity": "慢性冠状动脉狭窄",
"start_offset": 47,
"end_offset": 55,
"label": "dis"
},
{
"id": 6,
"entity": "心律失常",
"start_offset": 56,
"end_offset": 60,
"label": "dis"
},
{
"id": 7,
"entity": "心腔、冠状窦或腔静脉穿孔",
"start_offset": 61,
"end_offset": 73,
"label": "dis"
},
{
"id": 8,
"entity": "心包炎",
"start_offset": 74,
"end_offset": 77,
"label": "dis"
},
{
"id": 9,
"entity": "心肌坏死",
"start_offset": 78,
"end_offset": 82,
"label": "dis"
},
{
"id": 10,
"entity": "心力衰竭",
"start_offset": 83,
"end_offset": 87,
"label": "dis"
},
{
"id": 11,
"entity": "心源性休克",
"start_offset": 88,
"end_offset": 93,
"label": "dis"
},
{
"id": 12,
"entity": "肺静脉狭窄",
"start_offset": 94,
"end_offset": 99,
"label": "dis"
}
] |
第二节特发性弥漫性肺间质纤维化特发性弥漫性肺间质纤维化（idiopathicdiffuseinterstitialfibrosisofthelung）又称Hamman-Rich综合征，是一种弥漫性进行性肺间质纤维化状态，病因尚未明确，可能是各种炎症未控制的结果。
|
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"id": 0,
"entity": "特发性弥漫性肺间质纤维化",
"start_offset": 3,
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"label": "dis"
},
{
"id": 1,
"entity": "特发性弥漫性肺间质纤维化",
"start_offset": 15,
"end_offset": 27,
"label": "dis"
},
{
"id": 2,
"entity": "idiopathicdiffuseinterstitialfibrosisofthelung",
"start_offset": 28,
"end_offset": 74,
"label": "dis"
},
{
"id": 3,
"entity": "Hamman-Rich综合征",
"start_offset": 77,
"end_offset": 91,
"label": "dis"
},
{
"id": 4,
"entity": "肺间质",
"start_offset": 101,
"end_offset": 104,
"label": "bod"
}
] |
肺泡巨噬细胞可释放纤维化相关的趋化因子和刺激素，如纤维连接蛋白、肺泡巨噬细胞源性生长因子等起到重要作用。
|
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{
"id": 0,
"entity": "肺泡巨噬细胞",
"start_offset": 0,
"end_offset": 6,
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},
{
"id": 1,
"entity": "趋化因子",
"start_offset": 15,
"end_offset": 19,
"label": "bod"
},
{
"id": 2,
"entity": "刺激素",
"start_offset": 20,
"end_offset": 23,
"label": "bod"
},
{
"id": 3,
"entity": "纤维连接蛋白",
"start_offset": 25,
"end_offset": 31,
"label": "bod"
},
{
"id": 4,
"entity": "肺泡巨噬细胞源性生长因子",
"start_offset": 32,
"end_offset": 44,
"label": "bod"
}
] |
临床症状以干咳、气短、进行性呼吸困难、发绀为主，一般不发热，可有体重下降、乏力、食欲差。
|
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"entity": "干咳",
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{
"id": 1,
"entity": "气短",
"start_offset": 8,
"end_offset": 10,
"label": "sym"
},
{
"id": 2,
"entity": "进行性呼吸困难",
"start_offset": 11,
"end_offset": 18,
"label": "sym"
},
{
"id": 3,
"entity": "发绀",
"start_offset": 19,
"end_offset": 21,
"label": "sym"
},
{
"id": 4,
"entity": "一般不发热",
"start_offset": 24,
"end_offset": 29,
"label": "sym"
},
{
"id": 5,
"entity": "体重下降",
"start_offset": 32,
"end_offset": 36,
"label": "sym"
},
{
"id": 6,
"entity": "乏力",
"start_offset": 37,
"end_offset": 39,
"label": "sym"
},
{
"id": 7,
"entity": "食欲差",
"start_offset": 40,
"end_offset": 43,
"label": "sym"
}
] |
合并感染时有发热、咳脓痰、气急等。
|
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"entity": "发热",
"start_offset": 6,
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},
{
"id": 1,
"entity": "咳脓痰",
"start_offset": 9,
"end_offset": 12,
"label": "sym"
},
{
"id": 2,
"entity": "气急",
"start_offset": 13,
"end_offset": 15,
"label": "sym"
}
] |
体格检查见患儿发育极度不良、肺叩诊清音，在肺底部可闻细小捻发音或高调“爆裂”性啰音。
|
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"id": 1,
"entity": "发育极度不良",
"start_offset": 7,
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"label": "sym"
},
{
"id": 2,
"entity": "肺叩诊清音",
"start_offset": 14,
"end_offset": 19,
"label": "sym"
},
{
"id": 3,
"entity": "在肺底部可闻细小捻发音",
"start_offset": 20,
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"label": "sym"
},
{
"id": 4,
"entity": "高调“爆裂”性啰音",
"start_offset": 32,
"end_offset": 41,
"label": "sym"
}
] |
诊断主要根据临床、胸片及肺功能测定。
|
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"entity": "肺功能测定",
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"end_offset": 17,
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}
] |
胸部X线变化往往与病理变化一致，显示中下肺野弥漫性网点状阴影，随纤维化加重，出现粗条索状阴影。
|
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"id": 0,
"entity": "纤维化加重",
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},
{
"id": 1,
"entity": "粗条索状阴影",
"start_offset": 40,
"end_offset": 46,
"label": "sym"
}
] |
当肺间质纤维组织收缩时，肺泡及细支气管扩大，形成蜂窝状肺。
|
[
{
"id": 0,
"entity": "肺间质纤维组织",
"start_offset": 1,
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},
{
"id": 1,
"entity": "肺泡",
"start_offset": 12,
"end_offset": 14,
"label": "bod"
},
{
"id": 2,
"entity": "支气管",
"start_offset": 16,
"end_offset": 19,
"label": "bod"
},
{
"id": 3,
"entity": "肺",
"start_offset": 27,
"end_offset": 28,
"label": "bod"
}
] |
肺门淋巴结不肿大，肺活量减低。
|
[
{
"id": 0,
"entity": "肺门淋巴结",
"start_offset": 0,
"end_offset": 5,
"label": "bod"
}
] |
肺泡灌洗液中有较多炎症细胞和肥大细胞。
|
[
{
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"entity": "炎症细胞",
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"end_offset": 13,
"label": "bod"
},
{
"id": 1,
"entity": "肥大细胞",
"start_offset": 14,
"end_offset": 18,
"label": "bod"
}
] |
部分患者类风湿因子及抗核抗体可为阳性。
|
[
{
"id": 0,
"entity": "类风湿因子",
"start_offset": 4,
"end_offset": 9,
"label": "ite"
},
{
"id": 1,
"entity": "抗核抗体",
"start_offset": 10,
"end_offset": 14,
"label": "ite"
}
] |
以对症治疗为主，吸氧、抗感染、控制心力衰竭等。
|
[
{
"id": 0,
"entity": "对症治疗",
"start_offset": 1,
"end_offset": 5,
"label": "pro"
},
{
"id": 1,
"entity": "吸氧",
"start_offset": 8,
"end_offset": 10,
"label": "pro"
},
{
"id": 2,
"entity": "抗感染",
"start_offset": 11,
"end_offset": 14,
"label": "pro"
},
{
"id": 3,
"entity": "控制心力衰竭",
"start_offset": 15,
"end_offset": 21,
"label": "pro"
}
] |
皮质激素可缓解部分症状，但不能阻止其病情进展和改善肺功能。
|
[
{
"id": 0,
"entity": "皮质激素",
"start_offset": 0,
"end_offset": 4,
"label": "dru"
}
] |
无效者可试用免疫抑制剂或氯喹。
|
[
{
"id": 0,
"entity": "免疫抑制剂",
"start_offset": 6,
"end_offset": 11,
"label": "dru"
},
{
"id": 1,
"entity": "氯喹",
"start_offset": 12,
"end_offset": 14,
"label": "dru"
}
] |
进行性者多于2年内死于呼吸衰竭及肺心病，慢性者可存活20余年。
|
[
{
"id": 0,
"entity": "呼吸衰竭",
"start_offset": 11,
"end_offset": 15,
"label": "dis"
},
{
"id": 1,
"entity": "肺心病",
"start_offset": 16,
"end_offset": 19,
"label": "dis"
}
] |
第三节流行性感冒流行性感冒（influenza，简称流感），是由流行性感冒病毒（简称流感病毒）引起的一种常见急性呼吸道传染病。
|
[
{
"id": 0,
"entity": "流行性感冒",
"start_offset": 3,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "流行性感冒",
"start_offset": 8,
"end_offset": 13,
"label": "dis"
},
{
"id": 2,
"entity": "influenza",
"start_offset": 14,
"end_offset": 23,
"label": "dis"
},
{
"id": 3,
"entity": "流感",
"start_offset": 26,
"end_offset": 28,
"label": "dis"
},
{
"id": 4,
"entity": "流行性感冒病毒",
"start_offset": 32,
"end_offset": 39,
"label": "mic"
},
{
"id": 5,
"entity": "流感病毒",
"start_offset": 42,
"end_offset": 46,
"label": "mic"
},
{
"id": 6,
"entity": "急性呼吸道传染病",
"start_offset": 54,
"end_offset": 62,
"label": "dis"
}
] |
【病原和流行病学】流感病毒（influenzavirus）属正黏病毒科，基因组为单股正链RNA，其结构包括核衣壳（含NP蛋白）、蛋白壳（含M1蛋白）和包膜。
|
[
{
"id": 0,
"entity": "流感病毒",
"start_offset": 9,
"end_offset": 13,
"label": "mic"
},
{
"id": 1,
"entity": "influenzavirus",
"start_offset": 14,
"end_offset": 28,
"label": "mic"
},
{
"id": 2,
"entity": "正黏病毒",
"start_offset": 30,
"end_offset": 34,
"label": "mic"
}
] |
包膜来自病毒复制的宿主细胞，带有3种蛋白突起：①血凝素（HA）；②神经氨酸酶（NA）；③基质蛋白（M2）。
|
[
{
"id": 0,
"entity": "病毒",
"start_offset": 4,
"end_offset": 6,
"label": "mic"
},
{
"id": 1,
"entity": "宿主细胞",
"start_offset": 9,
"end_offset": 13,
"label": "bod"
},
{
"id": 2,
"entity": "血凝素",
"start_offset": 24,
"end_offset": 27,
"label": "mic"
},
{
"id": 3,
"entity": "HA",
"start_offset": 28,
"end_offset": 30,
"label": "mic"
},
{
"id": 4,
"entity": "神经氨酸酶",
"start_offset": 33,
"end_offset": 38,
"label": "mic"
},
{
"id": 5,
"entity": "NA",
"start_offset": 39,
"end_offset": 41,
"label": "mic"
}
] |
HA具有亚型和株特异性，能识别靶细胞表面受体，与靶细胞膜融合和诱导保护性中和抗体。
|
[
{
"id": 0,
"entity": "HA",
"start_offset": 0,
"end_offset": 2,
"label": "mic"
},
{
"id": 1,
"entity": "靶细胞",
"start_offset": 15,
"end_offset": 18,
"label": "bod"
},
{
"id": 2,
"entity": "靶细胞膜",
"start_offset": 24,
"end_offset": 28,
"label": "bod"
}
] |
NA亦具亚型和株特异性，其功能尚未完全明了，可使病毒从含唾液酸结构中游离出来，通过黏液层结合上皮靶细胞；促进HA被蛋白酶水解；还可破坏宿主细胞的HA受体，协助新生病毒颗粒再吸附于易感细胞，并防止病毒本身发生聚积。
|
[
{
"id": 0,
"entity": "NA",
"start_offset": 0,
"end_offset": 2,
"label": "mic"
},
{
"id": 1,
"entity": "病毒",
"start_offset": 24,
"end_offset": 26,
"label": "mic"
},
{
"id": 2,
"entity": "唾液酸",
"start_offset": 28,
"end_offset": 31,
"label": "mic"
},
{
"id": 3,
"entity": "黏液层",
"start_offset": 41,
"end_offset": 44,
"label": "bod"
},
{
"id": 4,
"entity": "上皮靶细胞",
"start_offset": 46,
"end_offset": 51,
"label": "bod"
},
{
"id": 5,
"entity": "HA",
"start_offset": 54,
"end_offset": 56,
"label": "mic"
},
{
"id": 6,
"entity": "宿主细胞",
"start_offset": 67,
"end_offset": 71,
"label": "bod"
},
{
"id": 7,
"entity": "HA",
"start_offset": 72,
"end_offset": 74,
"label": "mic"
},
{
"id": 8,
"entity": "病毒",
"start_offset": 81,
"end_offset": 83,
"label": "mic"
},
{
"id": 9,
"entity": "细胞",
"start_offset": 91,
"end_offset": 93,
"label": "bod"
},
{
"id": 10,
"entity": "病毒",
"start_offset": 97,
"end_offset": 99,
"label": "mic"
}
] |
根据病毒NP和M1蛋白抗原性不同，流感病毒分为甲、乙、丙3个型，根据HA和NA抗原性又分为若干亚型。
|
[
{
"id": 0,
"entity": "病毒NP",
"start_offset": 2,
"end_offset": 6,
"label": "mic"
},
{
"id": 1,
"entity": "流感病毒",
"start_offset": 17,
"end_offset": 21,
"label": "mic"
},
{
"id": 2,
"entity": "HA",
"start_offset": 34,
"end_offset": 36,
"label": "mic"
},
{
"id": 3,
"entity": "NA",
"start_offset": 37,
"end_offset": 39,
"label": "mic"
}
] |
流感病毒抗原性变异主要指HA和NA抗原性变异，有两种形式：①抗原性漂移（antigenicdrift）：变异幅度小，属量变，往往引起中小型流行；②抗原性转换（antigenicshift）：变异幅度大，系质变，形成新亚型。
|
[
{
"id": 0,
"entity": "流感病毒",
"start_offset": 0,
"end_offset": 4,
"label": "mic"
},
{
"id": 1,
"entity": "HA",
"start_offset": 12,
"end_offset": 14,
"label": "mic"
},
{
"id": 2,
"entity": "NA",
"start_offset": 15,
"end_offset": 17,
"label": "mic"
}
] |
分子流行病学研究显示，与流感流行关系最为密切的是HA基因。
|
[
{
"id": 0,
"entity": "流感",
"start_offset": 12,
"end_offset": 14,
"label": "dis"
},
{
"id": 1,
"entity": "HA",
"start_offset": 24,
"end_offset": 26,
"label": "mic"
}
] |
具流行病学意义变异株的HA分子至少有4个以上氨基酸发生替换，并分布在2个以上抗原决定簇区。
|
[
{
"id": 0,
"entity": "HA",
"start_offset": 11,
"end_offset": 13,
"label": "mic"
}
] |
流感病毒在鸡胚中生长较迅速，但传代易发生抗原性变异。
|
[
{
"id": 0,
"entity": "流感病毒",
"start_offset": 0,
"end_offset": 4,
"label": "mic"
}
] |
病毒分离可采用原代人胚肾细胞、猴肾细胞和传代犬肾及牛肾细胞等。
|
[
{
"id": 0,
"entity": "病毒",
"start_offset": 0,
"end_offset": 2,
"label": "mic"
},
{
"id": 1,
"entity": "人胚肾细胞",
"start_offset": 9,
"end_offset": 14,
"label": "bod"
}
] |
病毒对热、紫外线、乙醚等有机溶剂、甲醛和常用消毒剂均很敏感。
|
[
{
"id": 0,
"entity": "病毒",
"start_offset": 0,
"end_offset": 2,
"label": "mic"
},
{
"id": 1,
"entity": "乙醚",
"start_offset": 9,
"end_offset": 11,
"label": "dru"
},
{
"id": 2,
"entity": "甲醛",
"start_offset": 17,
"end_offset": 19,
"label": "dru"
},
{
"id": 3,
"entity": "消毒剂",
"start_offset": 22,
"end_offset": 25,
"label": "dru"
}
] |
患者自潜伏期末即有传染性，持续约1周；隐性感染者带毒时间短。
|
[
{
"id": 0,
"entity": "隐性感染",
"start_offset": 19,
"end_offset": 23,
"label": "sym"
}
] |
患者呼吸道分泌物中的颗粒可达1000000/ml以上，直径＜10μm的飞沫在空气中悬浮时间长，故在人群密集场所感染率高。
|
[
{
"id": 0,
"entity": "呼吸道分泌物",
"start_offset": 2,
"end_offset": 8,
"label": "bod"
}
] |
分泌物污染环境可间接传播病毒。
|
[
{
"id": 0,
"entity": "分泌物",
"start_offset": 0,
"end_offset": 3,
"label": "bod"
},
{
"id": 1,
"entity": "病毒",
"start_offset": 12,
"end_offset": 14,
"label": "mic"
}
] |
病后或接种后获同型病毒的免疫力，维持时间不超过2年。
|
[
{
"id": 0,
"entity": "病毒",
"start_offset": 9,
"end_offset": 11,
"label": "mic"
}
] |
我国流感流行存在南北地区差异：长江以南主要在冬、春季，长江以北主要在冬季。
|
[
{
"id": 0,
"entity": "流感",
"start_offset": 2,
"end_offset": 4,
"label": "dis"
}
] |
【发病机制和病理改变】流感病毒进入上呼吸道后停留于上皮细胞表面的黏液中。
|
[
{
"id": 0,
"entity": "流感病毒",
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"end_offset": 15,
"label": "mic"
},
{
"id": 1,
"entity": "上呼吸道",
"start_offset": 17,
"end_offset": 21,
"label": "bod"
},
{
"id": 2,
"entity": "上皮细胞",
"start_offset": 25,
"end_offset": 29,
"label": "bod"
},
{
"id": 3,
"entity": "黏液",
"start_offset": 32,
"end_offset": 34,
"label": "bod"
}
] |
若过去感染过类似毒株，其呼吸道局部抗体（主要为sIgA）能将病毒清除；若未感染过，病毒则进入细胞内复制，释放大量感染性病毒侵入邻近细胞，在1～2天内引起呼吸道广泛炎症。
|
[
{
"id": 0,
"entity": "感染",
"start_offset": 3,
"end_offset": 5,
"label": "sym"
},
{
"id": 1,
"entity": "呼吸道局部抗体",
"start_offset": 12,
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"label": "bod"
},
{
"id": 2,
"entity": "sIgA",
"start_offset": 23,
"end_offset": 27,
"label": "bod"
},
{
"id": 3,
"entity": "病毒",
"start_offset": 30,
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"label": "mic"
},
{
"id": 4,
"entity": "感染",
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},
{
"id": 5,
"entity": "病毒",
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"label": "mic"
},
{
"id": 6,
"entity": "细胞",
"start_offset": 46,
"end_offset": 48,
"label": "bod"
},
{
"id": 7,
"entity": "感染性病毒",
"start_offset": 56,
"end_offset": 61,
"label": "mic"
},
{
"id": 8,
"entity": "呼吸道广泛炎症",
"start_offset": 76,
"end_offset": 83,
"label": "dis"
}
] |
在少数抵抗力差者，感染下行造成间质性肺炎。
|
[
{
"id": 0,
"entity": "感染",
"start_offset": 9,
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"label": "sym"
},
{
"id": 1,
"entity": "间质性肺炎",
"start_offset": 15,
"end_offset": 20,
"label": "dis"
}
] |
当呼吸道黏膜被破坏时，部分病毒及其产物如HA、NA等进入血液，引起全身中毒症状。
|
[
{
"id": 0,
"entity": "呼吸道黏膜",
"start_offset": 1,
"end_offset": 6,
"label": "bod"
},
{
"id": 1,
"entity": "病毒",
"start_offset": 13,
"end_offset": 15,
"label": "mic"
},
{
"id": 2,
"entity": "HA",
"start_offset": 20,
"end_offset": 22,
"label": "mic"
},
{
"id": 3,
"entity": "NA",
"start_offset": 23,
"end_offset": 25,
"label": "mic"
},
{
"id": 4,
"entity": "血液",
"start_offset": 28,
"end_offset": 30,
"label": "bod"
},
{
"id": 5,
"entity": "中毒",
"start_offset": 35,
"end_offset": 37,
"label": "dis"
}
] |
流感病毒感染后，近100%的感染者产生局部抗体sIgA，能中和同亚型内不同毒株；约50%产生血清IgA。
|
[
{
"id": 0,
"entity": "流感病毒感染",
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"end_offset": 6,
"label": "dis"
},
{
"id": 1,
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},
{
"id": 2,
"entity": "局部抗体sIgA",
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},
{
"id": 3,
"entity": "血清IgA",
"start_offset": 46,
"end_offset": 51,
"label": "bod"
}
] |
特异性IgM和IgA在感染后2周内达峰值；而特异性IgG约在4～8周内达峰值。
|
[
{
"id": 0,
"entity": "特异性IgM和IgA",
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{
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},
{
"id": 2,
"entity": "特异性IgG",
"start_offset": 22,
"end_offset": 28,
"label": "bod"
}
] |
抗HA抗体是主要的保护性中和抗体；抗NA抗体不能中和病毒，但能抑制病毒从感染细胞释放。
|
[
{
"id": 0,
"entity": "抗HA抗体",
"start_offset": 0,
"end_offset": 5,
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},
{
"id": 1,
"entity": "抗NA抗体",
"start_offset": 17,
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},
{
"id": 2,
"entity": "病毒",
"start_offset": 26,
"end_offset": 28,
"label": "mic"
},
{
"id": 3,
"entity": "病毒",
"start_offset": 33,
"end_offset": 35,
"label": "mic"
},
{
"id": 4,
"entity": "感染细胞",
"start_offset": 36,
"end_offset": 40,
"label": "bod"
}
] |
特异性细胞毒性T细胞（CTL）可直接杀伤感染靶细胞，控制病毒在体内扩散；特异性CTL回忆反应能迅速清除再次感染的病毒而对再次感染有保护作用。
|
[
{
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{
"id": 1,
"entity": "CTL",
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},
{
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"entity": "感染靶细胞",
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"label": "bod"
},
{
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"entity": "病毒",
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},
{
"id": 4,
"entity": "特异性CTL",
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},
{
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},
{
"id": 6,
"entity": "病毒",
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"label": "mic"
},
{
"id": 7,
"entity": "感染",
"start_offset": 62,
"end_offset": 64,
"label": "sym"
}
] |
流感时，由于细胞免疫功能受抑制，易继发细菌感染。
|
[
{
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"entity": "流感",
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{
"id": 1,
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},
{
"id": 2,
"entity": "细菌感染",
"start_offset": 19,
"end_offset": 23,
"label": "dis"
}
] |
流感所致死亡多见于继发细菌感染或体弱并有其他慢性疾病者。
|
[
{
"id": 0,
"entity": "流感",
"start_offset": 0,
"end_offset": 2,
"label": "dis"
},
{
"id": 1,
"entity": "死亡",
"start_offset": 4,
"end_offset": 6,
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},
{
"id": 2,
"entity": "细菌感染",
"start_offset": 11,
"end_offset": 15,
"label": "dis"
},
{
"id": 3,
"entity": "体弱",
"start_offset": 16,
"end_offset": 18,
"label": "dis"
}
] |
呼吸道黏膜早期有单核细胞浸润及水肿,晚期见广泛上皮细胞坏死和出血性渗出物,但基底层细胞正常。
|
[
{
"id": 0,
"entity": "呼吸道黏膜",
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},
{
"id": 1,
"entity": "单核细胞",
"start_offset": 8,
"end_offset": 12,
"label": "bod"
},
{
"id": 2,
"entity": "早期有单核细胞浸润及水肿",
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},
{
"id": 3,
"entity": "上皮细胞",
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"label": "bod"
},
{
"id": 4,
"entity": "晚期见广泛上皮细胞坏死和出血性渗出物",
"start_offset": 18,
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"label": "sym"
},
{
"id": 5,
"entity": "基底层细胞正常",
"start_offset": 38,
"end_offset": 45,
"label": "sym"
}
] |
肺间质有水肿及炎性细胞浸润，肺泡内可有肺透明膜形成。
|
[
{
"id": 0,
"entity": "肺间质",
"start_offset": 0,
"end_offset": 3,
"label": "bod"
},
{
"id": 1,
"entity": "炎性细胞",
"start_offset": 7,
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},
{
"id": 2,
"entity": "肺间质有水肿及炎性细胞浸润",
"start_offset": 0,
"end_offset": 13,
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},
{
"id": 3,
"entity": "肺泡",
"start_offset": 14,
"end_offset": 16,
"label": "bod"
},
{
"id": 4,
"entity": "肺透明膜",
"start_offset": 19,
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"label": "bod"
},
{
"id": 5,
"entity": "肺泡内可有肺透明膜形成",
"start_offset": 14,
"end_offset": 25,
"label": "sym"
}
] |
（一）典型流感起病急，呼吸道卡他症状轻，而全身中毒症状明显，不同年龄儿童的临床表现各有差异。
|
[
{
"id": 0,
"entity": "起病急",
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},
{
"id": 1,
"entity": "呼吸道",
"start_offset": 11,
"end_offset": 14,
"label": "bod"
},
{
"id": 2,
"entity": "呼吸道卡他症状轻",
"start_offset": 11,
"end_offset": 19,
"label": "sym"
},
{
"id": 3,
"entity": "中毒",
"start_offset": 23,
"end_offset": 25,
"label": "dis"
},
{
"id": 4,
"entity": "全身中毒症状明显",
"start_offset": 21,
"end_offset": 29,
"label": "sym"
}
] |
1.新生儿流感突起高热或体温不升、拒乳、不安、衰弱，类似败血症。
|
[
{
"id": 0,
"entity": "新生儿流感",
"start_offset": 2,
"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "突起高热",
"start_offset": 7,
"end_offset": 11,
"label": "sym"
},
{
"id": 2,
"entity": "体温不升",
"start_offset": 12,
"end_offset": 16,
"label": "sym"
},
{
"id": 3,
"entity": "拒乳",
"start_offset": 17,
"end_offset": 19,
"label": "sym"
},
{
"id": 4,
"entity": "不安",
"start_offset": 20,
"end_offset": 22,
"label": "sym"
},
{
"id": 5,
"entity": "衰弱",
"start_offset": 23,
"end_offset": 25,
"label": "sym"
},
{
"id": 6,
"entity": "败血症",
"start_offset": 28,
"end_offset": 31,
"label": "dis"
},
{
"id": 7,
"entity": "类似败血症",
"start_offset": 26,
"end_offset": 31,
"label": "sym"
}
] |
但有鼻塞、流涕，提示病毒感染。
|
[
{
"id": 0,
"entity": "鼻塞",
"start_offset": 2,
"end_offset": 4,
"label": "sym"
},
{
"id": 1,
"entity": "流涕",
"start_offset": 5,
"end_offset": 7,
"label": "sym"
},
{
"id": 2,
"entity": "病毒感染",
"start_offset": 10,
"end_offset": 14,
"label": "dis"
}
] |
2.幼儿流感可发生上呼吸道感染、喉炎、气管炎、支气管炎、毛细支气管炎和肺炎等症。
|
[
{
"id": 0,
"entity": "幼儿流感",
"start_offset": 2,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "上呼吸道感染",
"start_offset": 9,
"end_offset": 15,
"label": "dis"
},
{
"id": 2,
"entity": "喉炎",
"start_offset": 16,
"end_offset": 18,
"label": "dis"
},
{
"id": 3,
"entity": "气管炎",
"start_offset": 19,
"end_offset": 22,
"label": "dis"
},
{
"id": 4,
"entity": "支气管炎",
"start_offset": 23,
"end_offset": 27,
"label": "dis"
},
{
"id": 5,
"entity": "毛细支气管炎",
"start_offset": 28,
"end_offset": 34,
"label": "dis"
},
{
"id": 6,
"entity": "肺炎",
"start_offset": 35,
"end_offset": 37,
"label": "dis"
}
] |
高热时易发生惊厥。
|
[
{
"id": 0,
"entity": "高热",
"start_offset": 0,
"end_offset": 2,
"label": "sym"
},
{
"id": 1,
"entity": "惊厥",
"start_offset": 6,
"end_offset": 8,
"label": "sym"
}
] |
3.学龄儿及青少年流感发病近似成人，急起畏寒高热，体温达39～41℃，面颊潮红，结膜充血，伴全身肌肉酸痛、头痛、乏力、食欲减退等全身症状及鼻塞、流涕、咽痛、干咳等呼吸道症状。
|
[
{
"id": 0,
"entity": "学龄儿及青少年流感",
"start_offset": 2,
"end_offset": 11,
"label": "dis"
},
{
"id": 1,
"entity": "急起畏寒高热",
"start_offset": 18,
"end_offset": 24,
"label": "sym"
},
{
"id": 2,
"entity": "体温达39～41℃",
"start_offset": 25,
"end_offset": 34,
"label": "sym"
},
{
"id": 3,
"entity": "面颊",
"start_offset": 35,
"end_offset": 37,
"label": "bod"
},
{
"id": 4,
"entity": "面颊潮红",
"start_offset": 35,
"end_offset": 39,
"label": "sym"
},
{
"id": 5,
"entity": "结膜",
"start_offset": 40,
"end_offset": 42,
"label": "bod"
},
{
"id": 6,
"entity": "结膜充血",
"start_offset": 40,
"end_offset": 44,
"label": "sym"
},
{
"id": 7,
"entity": "肌肉",
"start_offset": 48,
"end_offset": 50,
"label": "bod"
},
{
"id": 8,
"entity": "全身肌肉酸痛",
"start_offset": 46,
"end_offset": 52,
"label": "sym"
},
{
"id": 9,
"entity": "头痛",
"start_offset": 53,
"end_offset": 55,
"label": "sym"
},
{
"id": 10,
"entity": "乏力",
"start_offset": 56,
"end_offset": 58,
"label": "sym"
},
{
"id": 11,
"entity": "食欲减退",
"start_offset": 59,
"end_offset": 63,
"label": "sym"
},
{
"id": 12,
"entity": "鼻塞",
"start_offset": 69,
"end_offset": 71,
"label": "sym"
},
{
"id": 13,
"entity": "流涕",
"start_offset": 72,
"end_offset": 74,
"label": "sym"
},
{
"id": 14,
"entity": "咽痛",
"start_offset": 75,
"end_offset": 77,
"label": "sym"
},
{
"id": 15,
"entity": "干咳",
"start_offset": 78,
"end_offset": 80,
"label": "sym"
},
{
"id": 16,
"entity": "呼吸道",
"start_offset": 81,
"end_offset": 84,
"label": "bod"
}
] |
无并发症者热程一般2～5天，热退后全身症状好转，但呼吸道症状常持续1～2周。
|
[
{
"id": 0,
"entity": "呼吸道",
"start_offset": 25,
"end_offset": 28,
"label": "bod"
}
] |
丙型流感症状类似于普通感冒或典型流感，儿童少见。
|
[
{
"id": 0,
"entity": "丙型流感",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "普通感冒",
"start_offset": 9,
"end_offset": 13,
"label": "dis"
},
{
"id": 2,
"entity": "典型流感",
"start_offset": 14,
"end_offset": 18,
"label": "dis"
}
] |
（二）轻型流感急性起病，热度不高，呼吸道症状轻，全身症状不明显。
|
[
{
"id": 0,
"entity": "轻型流感",
"start_offset": 3,
"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "急性起病",
"start_offset": 7,
"end_offset": 11,
"label": "sym"
},
{
"id": 2,
"entity": "热度不高",
"start_offset": 12,
"end_offset": 16,
"label": "sym"
},
{
"id": 3,
"entity": "呼吸道",
"start_offset": 17,
"end_offset": 20,
"label": "bod"
},
{
"id": 4,
"entity": "呼吸道症状轻",
"start_offset": 17,
"end_offset": 23,
"label": "sym"
}
] |
（三）肺炎型流感（流感病毒性肺炎）见于老年、幼儿、体弱多病或正在使用免疫抑制剂者。
|
[
{
"id": 0,
"entity": "肺炎型流感",
"start_offset": 3,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "流感病毒性肺炎",
"start_offset": 9,
"end_offset": 16,
"label": "dis"
},
{
"id": 2,
"entity": "免疫抑制剂",
"start_offset": 34,
"end_offset": 39,
"label": "dru"
}
] |
起病与典型流感相似，1～2日内病情迅速加重，高热持续不退，剧咳带血样痰，烦躁不安，呼吸困难和发绀，可伴心力衰竭和脑病。
|
[
{
"id": 0,
"entity": "典型流感",
"start_offset": 3,
"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "高热持续不退",
"start_offset": 22,
"end_offset": 28,
"label": "sym"
},
{
"id": 2,
"entity": "血",
"start_offset": 32,
"end_offset": 33,
"label": "bod"
},
{
"id": 3,
"entity": "痰",
"start_offset": 34,
"end_offset": 35,
"label": "bod"
},
{
"id": 4,
"entity": "剧咳带血样痰",
"start_offset": 29,
"end_offset": 35,
"label": "sym"
},
{
"id": 5,
"entity": "烦躁不安",
"start_offset": 36,
"end_offset": 40,
"label": "sym"
},
{
"id": 6,
"entity": "呼吸困难",
"start_offset": 41,
"end_offset": 45,
"label": "sym"
},
{
"id": 7,
"entity": "发绀",
"start_offset": 46,
"end_offset": 48,
"label": "sym"
},
{
"id": 8,
"entity": "心力衰竭",
"start_offset": 51,
"end_offset": 55,
"label": "sym"
},
{
"id": 9,
"entity": "脑病",
"start_offset": 56,
"end_offset": 58,
"label": "sym"
}
] |
两肺密布湿啰音和喘鸣音。
|
[
{
"id": 0,
"entity": "肺",
"start_offset": 1,
"end_offset": 2,
"label": "bod"
},
{
"id": 1,
"entity": "两肺密布湿啰音和喘鸣音",
"start_offset": 0,
"end_offset": 11,
"label": "sym"
}
] |
【病原学诊断】（一）病毒分离病毒分离是发现新毒株的唯一方法。
|
[
{
"id": 0,
"entity": "病毒分离",
"start_offset": 10,
"end_offset": 14,
"label": "pro"
},
{
"id": 1,
"entity": "病毒分离",
"start_offset": 14,
"end_offset": 18,
"label": "pro"
}
] |
取发病5天内鼻咽分泌物，同时采用鸡胚羊膜腔接种和细胞培养可提高检出率。
|
[
{
"id": 0,
"entity": "鼻咽分泌物",
"start_offset": 6,
"end_offset": 11,
"label": "bod"
},
{
"id": 1,
"entity": "采用鸡胚羊膜腔接种和细胞培养",
"start_offset": 14,
"end_offset": 28,
"label": "pro"
}
] |
（二）快速诊断直接检查病毒抗原和病毒核酸的方法有：①病毒抗原检测，用免疫荧光法或免疫酶法检测鼻咽分泌物脱落细胞中病毒抗原；②病毒颗粒检查，用电镜或免疫电镜在症状出现24小时鼻咽分泌物沉渣中直接镜检病毒颗粒；③病毒基因检测，采用核酸杂交法或RT-PCR法检测鼻咽分泌物中病毒特异性基因。
|
[
{
"id": 0,
"entity": "病毒抗原",
"start_offset": 11,
"end_offset": 15,
"label": "mic"
},
{
"id": 1,
"entity": "病毒核酸",
"start_offset": 16,
"end_offset": 20,
"label": "mic"
},
{
"id": 2,
"entity": "病毒抗原",
"start_offset": 26,
"end_offset": 30,
"label": "mic"
},
{
"id": 3,
"entity": "免疫荧光法",
"start_offset": 34,
"end_offset": 39,
"label": "pro"
},
{
"id": 4,
"entity": "免疫酶法",
"start_offset": 40,
"end_offset": 44,
"label": "pro"
},
{
"id": 5,
"entity": "鼻咽分泌物脱落细胞",
"start_offset": 46,
"end_offset": 55,
"label": "bod"
},
{
"id": 6,
"entity": "病毒",
"start_offset": 56,
"end_offset": 58,
"label": "mic"
},
{
"id": 7,
"entity": "病毒颗粒检查",
"start_offset": 62,
"end_offset": 68,
"label": "pro"
},
{
"id": 8,
"entity": "电镜",
"start_offset": 70,
"end_offset": 72,
"label": "equ"
},
{
"id": 9,
"entity": "免疫电镜",
"start_offset": 73,
"end_offset": 77,
"label": "equ"
},
{
"id": 10,
"entity": "鼻咽分泌物",
"start_offset": 86,
"end_offset": 91,
"label": "bod"
},
{
"id": 11,
"entity": "镜检",
"start_offset": 96,
"end_offset": 98,
"label": "pro"
},
{
"id": 12,
"entity": "病毒",
"start_offset": 98,
"end_offset": 100,
"label": "mic"
},
{
"id": 13,
"entity": "病毒基因检测",
"start_offset": 104,
"end_offset": 110,
"label": "pro"
},
{
"id": 14,
"entity": "核酸杂交法",
"start_offset": 113,
"end_offset": 118,
"label": "pro"
},
{
"id": 15,
"entity": "RT-PCR法",
"start_offset": 119,
"end_offset": 126,
"label": "pro"
},
{
"id": 16,
"entity": "鼻咽分泌物",
"start_offset": 128,
"end_offset": 133,
"label": "bod"
},
{
"id": 17,
"entity": "病毒",
"start_offset": 134,
"end_offset": 136,
"label": "mic"
}
] |
（三）血清学诊断取双份血清（间隔2～4周），采用血凝抑制试验、特异性补体结合试验和中和试验检测相应特异性IgG抗体，滴度≥4倍增高有回顾性诊断意义。
|
[
{
"id": 0,
"entity": "血清学诊断",
"start_offset": 3,
"end_offset": 8,
"label": "pro"
},
{
"id": 1,
"entity": "血清",
"start_offset": 11,
"end_offset": 13,
"label": "bod"
},
{
"id": 2,
"entity": "血凝抑制试验",
"start_offset": 24,
"end_offset": 30,
"label": "pro"
},
{
"id": 3,
"entity": "特异性补体结合试验",
"start_offset": 31,
"end_offset": 40,
"label": "pro"
},
{
"id": 4,
"entity": "中和试验检测相应特异性IgG抗体",
"start_offset": 41,
"end_offset": 57,
"label": "pro"
}
] |
用ELISA法检测特异性IgM和IgA可诊断之。
|
[
{
"id": 0,
"entity": "ELISA法",
"start_offset": 1,
"end_offset": 7,
"label": "pro"
},
{
"id": 1,
"entity": "特异性IgM和IgA",
"start_offset": 9,
"end_offset": 19,
"label": "bod"
}
] |
【预防和治疗】（一）药物预防1.金刚烷胺（amantadine）主要用于甲型流感的预防。
|
[
{
"id": 0,
"entity": "金刚烷胺",
"start_offset": 16,
"end_offset": 20,
"label": "dru"
},
{
"id": 1,
"entity": "amantadine",
"start_offset": 21,
"end_offset": 31,
"label": "dru"
},
{
"id": 2,
"entity": "甲型流感",
"start_offset": 36,
"end_offset": 40,
"label": "dis"
}
] |
2.金刚乙胺（rimantadine）用于甲型流感的预防。
|
[
{
"id": 0,
"entity": "金刚乙胺",
"start_offset": 2,
"end_offset": 6,
"label": "dru"
},
{
"id": 1,
"entity": "rimantadine",
"start_offset": 7,
"end_offset": 18,
"label": "dru"
},
{
"id": 2,
"entity": "甲型流感",
"start_offset": 21,
"end_offset": 25,
"label": "dis"
}
] |
吸入给药已成功用于成人的预防，尚未见儿童群体预防用药的报道。
|
[
{
"id": 0,
"entity": "吸入给药",
"start_offset": 0,
"end_offset": 4,
"label": "pro"
}
] |
（二）疫苗接种由于流感病毒抗原易变异，WHO流感协作中心每年定期发布次年流感疫苗抗原成分的建议。
|
[
{
"id": 0,
"entity": "疫苗接种",
"start_offset": 3,
"end_offset": 7,
"label": "pro"
},
{
"id": 1,
"entity": "流感病毒抗原",
"start_offset": 9,
"end_offset": 15,
"label": "mic"
},
{
"id": 2,
"entity": "WHO流感",
"start_offset": 19,
"end_offset": 24,
"label": "dis"
},
{
"id": 3,
"entity": "流感疫苗",
"start_offset": 36,
"end_offset": 40,
"label": "dru"
}
] |
1.灭活疫苗目前多采用多价纯化的灭活疫苗或裂解的亚单位疫苗（保留HA和NA，去除核酸），接种者不良反应减少，但免疫原性不如纯化的全毒株疫苗。
|
[
{
"id": 0,
"entity": "灭活疫苗",
"start_offset": 2,
"end_offset": 6,
"label": "dru"
},
{
"id": 1,
"entity": "灭活疫苗",
"start_offset": 16,
"end_offset": 20,
"label": "dru"
},
{
"id": 2,
"entity": "亚单位疫苗",
"start_offset": 24,
"end_offset": 29,
"label": "dru"
},
{
"id": 3,
"entity": "HA",
"start_offset": 32,
"end_offset": 34,
"label": "mic"
},
{
"id": 4,
"entity": "NA",
"start_offset": 35,
"end_offset": 37,
"label": "mic"
},
{
"id": 5,
"entity": "纯化的全毒株疫苗",
"start_offset": 61,
"end_offset": 69,
"label": "dru"
}
] |
将佐剂与亚单位疫苗一起应用，可提高疫苗的效果。
|
[
{
"id": 0,
"entity": "亚单位疫苗",
"start_offset": 4,
"end_offset": 9,
"label": "dru"
},
{
"id": 1,
"entity": "疫苗",
"start_offset": 17,
"end_offset": 19,
"label": "dru"
}
] |
2.减毒活疫苗鼻内给药，使病毒只在上呼吸道增殖，刺激产生局部和体液免疫，已用于成人和儿童，显示良好的免疫原性。
|
[
{
"id": 0,
"entity": "减毒活疫苗",
"start_offset": 2,
"end_offset": 7,
"label": "dru"
},
{
"id": 1,
"entity": "鼻内给药",
"start_offset": 7,
"end_offset": 11,
"label": "pro"
},
{
"id": 2,
"entity": "病毒",
"start_offset": 13,
"end_offset": 15,
"label": "mic"
},
{
"id": 3,
"entity": "上呼吸道",
"start_offset": 17,
"end_offset": 21,
"label": "bod"
},
{
"id": 4,
"entity": "体液",
"start_offset": 31,
"end_offset": 33,
"label": "bod"
}
] |
（三）综合对症治疗卧床休息，多饮水，加强护理，预防并发症。
|
[
{
"id": 0,
"entity": "治疗卧床休息",
"start_offset": 7,
"end_offset": 13,
"label": "pro"
},
{
"id": 1,
"entity": "多饮水",
"start_offset": 14,
"end_offset": 17,
"label": "pro"
},
{
"id": 2,
"entity": "加强护理",
"start_offset": 18,
"end_offset": 22,
"label": "pro"
}
] |
剧咳者给予镇咳祛痰剂。
|
[
{
"id": 0,
"entity": "剧咳",
"start_offset": 0,
"end_offset": 2,
"label": "sym"
},
{
"id": 1,
"entity": "镇咳祛痰剂",
"start_offset": 5,
"end_offset": 10,
"label": "dru"
}
] |
继发细菌感染时给予相应抗生素（一般不必预防性用药）。
|
[
{
"id": 0,
"entity": "细菌感染",
"start_offset": 2,
"end_offset": 6,
"label": "sym"
},
{
"id": 1,
"entity": "抗生素",
"start_offset": 11,
"end_offset": 14,
"label": "dru"
}
] |
（四）抗病毒治疗1.金刚烷胺用于治疗无并发症的甲型流感。
|
[
{
"id": 0,
"entity": "抗病毒治疗",
"start_offset": 3,
"end_offset": 8,
"label": "pro"
},
{
"id": 1,
"entity": "金刚烷胺",
"start_offset": 10,
"end_offset": 14,
"label": "dru"
},
{
"id": 2,
"entity": "甲型流感",
"start_offset": 23,
"end_offset": 27,
"label": "dis"
}
] |
2.扎那米韦用于治疗甲型和乙型流感。
|
[
{
"id": 0,
"entity": "扎那米韦",
"start_offset": 2,
"end_offset": 6,
"label": "dru"
},
{
"id": 1,
"entity": "甲型和乙型流感",
"start_offset": 10,
"end_offset": 17,
"label": "dis"
}
] |
儿童用量：吸入10mg，一日2次，疗程10天，病程早期（36小时内）开始用药。
|
[
{
"id": 0,
"entity": "吸入",
"start_offset": 5,
"end_offset": 7,
"label": "pro"
}
] |
3.Oseltavirir为NA抑制剂。
|
[
{
"id": 0,
"entity": "Oseltavirir",
"start_offset": 2,
"end_offset": 13,
"label": "dru"
},
{
"id": 1,
"entity": "NA抑制剂",
"start_offset": 14,
"end_offset": 19,
"label": "dru"
}
] |
二、小儿神经系统的解剖生理特点（一）脑和脊髓的发育特点神经系统的发育在胎儿期最早开始。
|
[
{
"id": 0,
"entity": "神经系统",
"start_offset": 4,
"end_offset": 8,
"label": "bod"
},
{
"id": 1,
"entity": "脑",
"start_offset": 18,
"end_offset": 19,
"label": "bod"
},
{
"id": 2,
"entity": "脊髓",
"start_offset": 20,
"end_offset": 22,
"label": "bod"
},
{
"id": 3,
"entity": "神经系统",
"start_offset": 27,
"end_offset": 31,
"label": "bod"
}
] |
在婴儿期，甚至整个小儿时期，神经精神发育一直十分活跃。
|
[
{
"id": 0,
"entity": "神经",
"start_offset": 14,
"end_offset": 16,
"label": "bod"
}
] |
出生时小儿脑重平均370g，占体重的10%～12%，为成人脑重（约1500g）的25%左右。
|
[
{
"id": 0,
"entity": "小儿脑重",
"start_offset": 3,
"end_offset": 7,
"label": "ite"
},
{
"id": 1,
"entity": "体重",
"start_offset": 15,
"end_offset": 17,
"label": "ite"
},
{
"id": 2,
"entity": "成人脑重",
"start_offset": 27,
"end_offset": 31,
"label": "ite"
}
] |
6个月婴儿脑重600～700g，1岁时达900g，2岁时达1000g左右，4～6岁时脑重已达成人脑重的85%～90%。
|
[
{
"id": 0,
"entity": "脑重",
"start_offset": 5,
"end_offset": 7,
"label": "ite"
},
{
"id": 1,
"entity": "脑重",
"start_offset": 42,
"end_offset": 44,
"label": "ite"
},
{
"id": 2,
"entity": "成人脑重",
"start_offset": 46,
"end_offset": 50,
"label": "ite"
}
] |
出生时大脑已有主要的沟回，但皮层较薄、沟裂较浅。
|
[
{
"id": 0,
"entity": "大脑",
"start_offset": 3,
"end_offset": 5,
"label": "bod"
},
{
"id": 1,
"entity": "沟回",
"start_offset": 10,
"end_offset": 12,
"label": "bod"
},
{
"id": 2,
"entity": "皮层较薄",
"start_offset": 14,
"end_offset": 18,
"label": "sym"
},
{
"id": 3,
"entity": "沟裂较浅",
"start_offset": 19,
"end_offset": 23,
"label": "sym"
}
] |
新生儿神经细胞数目与成人相同，但其树突与轴突少而短脑重的增加主要由于神经细胞体积增大和树突的增多、加长，以及神经髓鞘的形成和发育；3岁时神经细胞分化已基本完成，8岁时接近成人。
|
[
{
"id": 0,
"entity": "神经细胞",
"start_offset": 3,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "轴突",
"start_offset": 20,
"end_offset": 22,
"label": "bod"
},
{
"id": 2,
"entity": "树突与轴突少而短",
"start_offset": 17,
"end_offset": 25,
"label": "sym"
},
{
"id": 3,
"entity": "脑重",
"start_offset": 25,
"end_offset": 27,
"label": "ite"
},
{
"id": 4,
"entity": "神经髓鞘",
"start_offset": 54,
"end_offset": 58,
"label": "bod"
},
{
"id": 5,
"entity": "神经细胞",
"start_offset": 68,
"end_offset": 72,
"label": "bod"
}
] |
神经纤维的发育较晚，始于胚胎7个月，到4岁时完成髓鞘化。
|
[
{
"id": 0,
"entity": "神经纤维",
"start_offset": 0,
"end_offset": 4,
"label": "bod"
},
{
"id": 1,
"entity": "髓鞘化",
"start_offset": 24,
"end_offset": 27,
"label": "sym"
}
] |
故婴儿期各种刺激引起的神经冲动传导缓慢，且易于泛化，不易形成兴奋灶，易于疲劳。
|
[
{
"id": 0,
"entity": "易于泛化",
"start_offset": 21,
"end_offset": 25,
"label": "sym"
},
{
"id": 1,
"entity": "不易形成兴奋灶",
"start_offset": 26,
"end_offset": 33,
"label": "sym"
},
{
"id": 2,
"entity": "易于疲劳",
"start_offset": 34,
"end_offset": 38,
"label": "sym"
}
] |
出生时大脑皮质下中枢如丘脑、下丘脑以及苍白球等发育已较成熟，初生婴儿的活动主要由皮质下系统调节。
|
[
{
"id": 0,
"entity": "大脑皮质下中枢",
"start_offset": 3,
"end_offset": 10,
"label": "bod"
},
{
"id": 1,
"entity": "丘脑",
"start_offset": 11,
"end_offset": 13,
"label": "bod"
},
{
"id": 2,
"entity": "下丘脑",
"start_offset": 14,
"end_offset": 17,
"label": "bod"
},
{
"id": 3,
"entity": "苍白球",
"start_offset": 19,
"end_offset": 22,
"label": "bod"
},
{
"id": 4,
"entity": "皮质",
"start_offset": 40,
"end_offset": 42,
"label": "bod"
}
] |
随着大脑皮层的发育成熟，运动逐渐转为由大脑皮层中枢调节，对皮质下中枢的抑制作用也趋明显。
|
[
{
"id": 0,
"entity": "大脑皮层",
"start_offset": 2,
"end_offset": 6,
"label": "bod"
},
{
"id": 1,
"entity": "大脑皮层中枢",
"start_offset": 19,
"end_offset": 25,
"label": "bod"
},
{
"id": 2,
"entity": "皮质下中枢",
"start_offset": 29,
"end_offset": 34,
"label": "bod"
}
] |
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