Division of Infectious Diseases, Department of Pediatrics, University Medical Centre Utrecht, Utrecht 3508 AB, The Netherlands.
Pediatr Infect Dis J. 2010 Jan;29(1):39-42. doi: 10.1097/INF.0b013e3181b34e52.
Respiratory syncytial virus (RSV)-induced lower respiratory tract infection (LRTI) is associated with the subsequent development of recurrent wheeze. In a recent study, we found a high incidence (9.9%) of hospitalization for RSV-induced LRTI among children with Down syndrome (DS), indicating DS as a new risk factor for RSV-induced LRTI. In the current study we aimed to investigate the development of long-term airway morbidity in children with DS after hospitalization for RSV-induced LRTI.
A combined retrospective cohort and prospective birth cohort of children with DS with a history of hospitalization for RSV-induced LRTI was studied (n = 53). Three control populations were included: children with DS without hospitalization for RSV-induced LRTI (n = 110), children without DS but with hospitalization for RSV-induced LRTI (n = 48), and healthy siblings of the previous 3 groups mentioned (n = 49). The primary outcome was physician-diagnosed wheeze up to 2 years of age.
The incidence of physician-diagnosed recurrent wheeze in children with DS with a history of hospitalization for RSV-induced LRTI was 36%. Unexpectedly, up to 30% of children with DS without a history of RSV-induced LRTI had physician-diagnosed recurrent wheeze (no significant difference). In children without DS physician-diagnosed wheeze was found more frequently in children hospitalized for RSV-induced LRTI than healthy controls (31% vs. 8%, P = 0.004).
In this combined retrospective/prospective cohort study RSV-induced LRTI did not significantly contribute to the risk of recurrent wheeze in children with DS. An unexpected finding was that recurrent wheeze was very common among children with DS.
呼吸道合胞病毒（RSV）引起的下呼吸道感染（LRTI）与随后反复喘息的发展有关。在最近的一项研究中，我们发现唐氏综合征（DS）患儿因 RSV 引起的 LRTI 住院的发生率很高（9.9%），表明 DS 是 RSV 引起的 LRTI 的新危险因素。在目前的研究中，我们旨在研究因 RSV 引起的 LRTI 住院后 DS 患儿的长期气道发病情况。
研究了一组有因 RSV 引起的 LRTI 住院史的 DS 患儿的回顾性队列和前瞻性出生队列（n=53）。纳入了三个对照组：无因 RSV 引起的 LRTI 住院史的 DS 患儿（n=110）、无 DS 但因 RSV 引起的 LRTI 住院史的患儿（n=48）和上述 3 组的健康兄弟姐妹（n=49）。主要结局是 2 岁以下医生诊断的喘息。
有因 RSV 引起的 LRTI 住院史的 DS 患儿反复喘息的发生率为 36%。出乎意料的是，多达 30%的无 RSV 引起的 LRTI 住院史的 DS 患儿有医生诊断的反复喘息（无显著差异）。在无 DS 的患儿中，因 RSV 引起的 LRTI 住院的患儿比健康对照组更常出现医生诊断的喘息（31% vs. 8%，P=0.004）。
在这项回顾性/前瞻性队列研究中，RSV 引起的 LRTI 并没有显著增加 DS 患儿反复喘息的风险。一个意外的发现是，DS 患儿反复喘息非常常见。
