Glezen W P, Greenberg S B, Atmar R L, Piedra P A, Couch R B
Department of Microbiology and Immunology, Baylor College of Medicine, Houston, Tex 77030, USA.
JAMA. 2000 Jan 26;283(4):499-505. doi: 10.1001/jama.283.4.499.
While hospitalization rates have declined overall, hospitalizations for acute lower respiratory tract infections have increased steadily since 1980. Development of new approaches for prevention of acute respiratory tract conditions requires studies of the etiologies of infections and quantification of the risk of hospitalization for vulnerable patients.
To determine the frequency of specific virus infections associated with acute respiratory tract conditions leading to hospitalization of chronically ill patients.
Analysis of viral etiology of patients hospitalized with acute respiratory tract conditions between July 1991 and June 1995.
Four large clinics and related hospitals serving diverse populations representative of Harris County, Texas.
A total of 1029 patients who were hospitalized for pneumonia, tracheobronchitis, bronchiolitis, croup, exacerbations of asthma or chronic obstructive pulmonary disease, and/or congestive heart failure.
Virus infection, defined by culture, antigen detection, and significant rise in serum antibodies, by underlying condition; hospitalization rates by low- vs middle-income status.
Ninety-three percent of patients older than 5 years had a chronic underlying condition; a chronic pulmonary condition was most common. Patients with chronic pulmonary disease from low-income populations were hospitalized at a rate of 398.6 per 10000, almost 8 times higher than the rate for patients from middle-income groups (52.2 per 10000; P<.001). Of the 403 patients (44.4% of adults and 32.3% of children) who submitted convalescent serum specimens for antibody testing, respiratory tract virus infections were detected in 181 (44.9%). Influenza, parainfluenza, and respiratory syncytial virus (RSV) infections accounted for 75% of all virus infections.
Our study suggests that respiratory virus infections commonly trigger serious acute respiratory conditions that result in hospitalization of patients with chronic underlying conditions, highlighting the need for development of effective vaccines for these viruses, especially for parainfluenza and RSV.
虽然总体住院率有所下降，但自1980年以来，急性下呼吸道感染的住院人数却在稳步增加。开发预防急性呼吸道疾病的新方法需要对感染病因进行研究，并对易感患者的住院风险进行量化。
确定与导致慢性病患者住院的急性呼吸道疾病相关的特定病毒感染的频率。
对1991年7月至1995年6月期间因急性呼吸道疾病住院的患者的病毒病因进行分析。
德克萨斯州哈里斯县的四家大型诊所及相关医院，服务于不同人群，具有代表性。
共有1029例因肺炎、气管支气管炎、细支气管炎、哮吼、哮喘或慢性阻塞性肺疾病加重和/或充血性心力衰竭住院的患者。
通过培养、抗原检测和血清抗体显著升高定义的病毒感染情况，按基础疾病分类；按低收入与中等收入状况划分的住院率。
5岁以上患者中有93%患有慢性基础疾病；慢性肺部疾病最为常见。低收入人群中患有慢性肺部疾病的患者住院率为每10000人398.6例，几乎是中等收入组患者住院率（每10000人52.2例）的8倍（P<0.001）。在提交恢复期血清标本进行抗体检测的403例患者（占成人的44.4%，儿童的32.3%）中，181例（44.9%）检测到呼吸道病毒感染。流感、副流感和呼吸道合胞病毒（RSV）感染占所有病毒感染的75%。
我们的研究表明，呼吸道病毒感染通常会引发严重的急性呼吸道疾病，导致患有慢性基础疾病的患者住院，这凸显了开发针对这些病毒，尤其是针对副流感和RSV的有效疫苗的必要性。
