Research Unit for Neonatal Infectious Diseases and Epidemiology, Division of Neonatology, Department of Pediatrics, Medical University of Graz, Austria.
Early Hum Dev. 2011 Mar;87 Suppl 1:S47-9. doi: 10.1016/j.earlhumdev.2011.01.010. Epub 2011 Jan 26.
Preterm infants are at increased risk of being rehospitalised during the first few months of life with severe respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) that usually manifests as apnea and hypoxemia. This occurs more commonly in preterm infants < 33 weeks gestational age (GA), but recent studies demonstrate that late preterm infants (those born between 34 weeks and 0 days to 36 weeks and 6 days GA) are equally susceptible to RSV LRTI as those with lower GA. Factors associated with severe LRTI include immaturity of both the humoral and cell-mediated immune system and interrupted lung development prior to 36 weeks GA which results in lower functional residual capacity, reduced compliance, diminished forced expiratory air flow and impaired gas exchange. Morbidity and mortality are significantly increased in late preterms compared to their term counterparts. Prophylaxis with palivizumab against RSV infection seems to be crucial. Due to the large number of infants in this age group, additional risk factors have been identified in order to tailor palivizumab prophylaxis effectively to those at highest risk for severe RSV LRTI.
早产儿在生命的头几个月因严重呼吸道合胞病毒（RSV）下呼吸道感染（LRTI）而再次住院的风险增加，这种感染通常表现为呼吸暂停和低氧血症。这种情况在胎龄（GA）<33 周的早产儿中更为常见，但最近的研究表明，晚期早产儿（出生于 34 周至 0 天至 36 周加 6 天 GA）与低 GA 的早产儿一样容易受到 RSV LRTI 的影响。与严重 LRTI 相关的因素包括体液和细胞介导的免疫系统不成熟以及 GA 前 36 周的肺发育中断，这导致功能残气量降低、顺应性降低、呼气流量减少和气体交换受损。与足月婴儿相比，晚期早产儿的发病率和死亡率显著增加。针对 RSV 感染的帕利珠单抗预防似乎至关重要。由于该年龄段婴儿数量众多，为了有效地针对那些患严重 RSV LRTI 风险最高的婴儿进行帕利珠单抗预防，已经确定了其他危险因素。
