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[患有/未患有支气管肺发育不良的早产儿呼吸道合胞病毒(RSV)的预防:高免疫球蛋白(RSV-IGIV)和帕利珠单抗(MEDI-493)]

[Prophylaxis of respiratory syncytial virus (RSV) in preterm infants with/without bronchopulmonary dysplasia: hyperimmune globulin (RSV-IGIV) and palivizumab (MEDI-493)].

作者信息

Resch B, Müller W

机构信息

Klinische Abteilung für Neonatologie, Universitätsklinik für Kinder- und Jugendheilkunde Graz.

出版信息

Klin Padiatr. 1999 Nov-Dec;211(6):450-5. doi: 10.1055/s-2008-1043832.

Abstract

Respiratory syncytial virus (RSV) causes seasonal epidemics between December and March (April) and remains the main agent that causes severe lower respiratory tract infections in young infants. Children with bronchopulmonary dysplasia up to 24 months of age and preterm infants with a gestational age of 32 weeks and below, who are less than six months of age, are at highest risk for severe RSV infection. RSV-IGIV has been demonstrated to reduce significantly RSV associated hospitalizations, RSV associated hospital days and the incidence of severe RSV lower respiratory tract infections. Monthly infusions during RSV season were safe and well tolerated. Adverse events related to the hyperimmune globulin infusion were generally mild (< 3%) including fluid overload, decreased oxygen saturation and fever. Palivizumab, an intramuscularly administered humanized monoclonal antibody (RSV-glycoprotein-F antibody), will be preferable for the future because of ease of administration and comparable reduction in the risk of hospitalization. RSV-IGIV and palivizumab are both cost expansive and prophylaxis should be limited to high-risk infants.

摘要

呼吸道合胞病毒(RSV)在12月至次年3月(4月)引发季节性流行,仍是导致小婴儿严重下呼吸道感染的主要病原体。年龄在24个月以下的支气管肺发育不良儿童以及胎龄32周及以下、年龄小于6个月的早产儿,发生严重RSV感染的风险最高。已证实RSV免疫球蛋白静脉注射剂(RSV-IGIV)可显著减少与RSV相关的住院次数、与RSV相关的住院天数以及严重RSV下呼吸道感染的发生率。在RSV流行季节每月输注是安全的,且耐受性良好。与高免疫球蛋白输注相关的不良事件通常较轻(<3%),包括液体超负荷、氧饱和度降低和发热。帕利珠单抗是一种肌肉注射的人源化单克隆抗体(RSV糖蛋白-F抗体),由于给药方便且降低住院风险的效果相当,未来将更受青睐。RSV-IGIV和帕利珠单抗成本都很高,预防应仅限于高危婴儿。

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