Greenough Anne, Broughton Simon
Division of Asthma, Allergy and Lung Biology, and National Intensive Care Center, 4th floor Golden Jubilee Wing, Guy's, King's and St. Thomas' School of Medicine, King's College, London SE5 9RS, United Kingdom.
Pediatr Infect Dis J. 2005 Nov;24(11 Suppl):S184-7, discussion S187-8. doi: 10.1097/01.inf.0000188195.22502.54.
Respiratory syncytial virus (RSV) infection in healthy infants born at term results in long term sequelae. Infants born prematurely are at increased risk of severe acute RSV infection; thus it would seem likely that such infants would be at increased risk of long term respiratory sequelae.
Methods of assessing the long term outcome of RSV infection are discussed and the results of retrospective and prospective studies investigating chronic respiratory morbidity after RSV infection in premature infants are reviewed.
Documentation of all health care utilization, parental documentation of symptom status and lung function measurement provide a comprehensive and quantitative assessment of respiratory outcome. Studies that have included such outcome measures have demonstrated that RSV hospitalization in infants born between 32 and 35 weeks of gestational age and in those born more prematurely who developed chronic lung disease was associated with more hospital admissions, inpatient days, physician contacts and outpatient visits in the first 2 years after birth. Children born before 32 weeks of gestation who developed chronic lung disease also required more outpatient attendances and prescriptions and respiratory medications in years 2 through 4. Prospective data collection has demonstrated that chronic respiratory morbidity occurs in very premature infants, regardless of whether their RSV infection required hospitalization.
Chronic respiratory morbidity is increased in premature infants after RSV infection. The duration of this increased morbidity and the impact of other viral infections, particularly dual infection with RSV, on long term sequelae merit investigation.
足月出生的健康婴儿感染呼吸道合胞病毒（RSV）会导致长期后遗症。早产儿发生严重急性RSV感染的风险增加；因此，这类婴儿出现长期呼吸道后遗症的风险似乎也会增加。
讨论了评估RSV感染长期结局的方法，并综述了调查早产儿RSV感染后慢性呼吸道疾病的回顾性和前瞻性研究结果。
对所有医疗保健利用情况的记录、家长对症状状态的记录以及肺功能测量，可对呼吸结局进行全面和定量评估。纳入此类结局指标的研究表明，孕32至35周出生的婴儿以及出生更早产且患有慢性肺病的婴儿，RSV住院与出生后头两年更多的住院次数、住院天数、医生诊疗次数和门诊就诊次数相关。孕32周前出生且患有慢性肺病的儿童在第2至4年也需要更多的门诊就诊次数、处方和呼吸药物。前瞻性数据收集表明，极早产儿会出现慢性呼吸道疾病，无论其RSV感染是否需要住院治疗。
RSV感染后早产儿的慢性呼吸道疾病发生率增加。这种发病率增加的持续时间以及其他病毒感染，特别是RSV双重感染对长期后遗症的影响值得研究。
