Hancock David G, Charles-Britton Billie, Dixon Dani-Louise, Forsyth Kevin D
Department of Paediatrics and Child Health, Flinders University, Bedford Park, Australia.
Intensive and Critical Care Unit, Flinders University and Flinders Medical Centre, Bedford Park, Australia.
Pediatr Pulmonol. 2017 Sep;52(9):1234-1240. doi: 10.1002/ppul.23750. Epub 2017 Jul 3.
Viral bronchiolitis is one of the most common hospital presentations in infancy and as such represents a major healthcare burden worldwide. However despite this, there are currently no effective targeted therapies nor can those infants at highest risk for developing severe disease or subsequent respiratory morbidity be predicted on initial hospital presentation. Current definitions of bronchiolitis in the published literature vary significantly in terms of the age range at presentation, specific clinical symptoms, causative virus, and the inclusion or exclusion of infants with previous presentations and/or various comorbidities. In this review, we highlight how this heterogeneity among definitions contributes to a lack of clarity on this condition and its likely multiple endotypes. We argue that without a new universal consensus definition or sets of definitions, progress into bronchiolitis will continue to be stalled.
病毒性细支气管炎是婴儿期最常见的住院疾病之一，因此在全球范围内构成了重大的医疗负担。然而，尽管如此，目前尚无有效的靶向治疗方法，也无法在初次住院时预测哪些婴儿发生重症疾病或随后出现呼吸道疾病的风险最高。已发表文献中目前对细支气管炎的定义在发病年龄范围、具体临床症状、致病病毒以及既往发病和/或各种合并症婴儿的纳入或排除方面存在显著差异。在本综述中，我们强调了定义之间的这种异质性如何导致对这种疾病及其可能的多种内型缺乏清晰认识。我们认为，如果没有新的通用共识定义或一系列定义，细支气管炎研究的进展将继续受阻。
