Penn C C, Liu C
Division of Infectious Diseases, University of Kansas School of Medicine, Kansas City.
Clin Chest Med. 1993 Dec;14(4):645-54.
Since its recognition as a clinical entity in the 1940s, our knowledge of bronchiolitis has grown with respect to the breadth of disease, epidemiology, treatment, and long-term effects. Bronchiolitis occurs most commonly in infants and children in association with a predictably small number of respiratory pathogens. Our knowledge of the association of bronchiolitis to subsequent wheezing is in a state of evolution. Rarely, bronchiolitis may progress to a chronic obstructive process, bronchiolitis obliterans, seen most often following adenovirus infection. The diagnosis of bronchiolitis in adults is relatively rare and although specific information on etiologic agents is lacking, it is not unlikely that the implicated infectious agents in infant bronchiolitis may play a role in the adult form of the disease. Bronchiolitis obliterans in adults occurs as a result of many possible causes, including infection. Although infection probably contributes to the pathogenesis of bronchiolitis obliterans in the post-organ-transplant population, this process appears to be a complex interaction centering around graft rejection.
自20世纪40年代被确认为一种临床实体以来，我们对细支气管炎的认识在疾病范围、流行病学、治疗及长期影响等方面都有所增长。细支气管炎最常见于婴幼儿，与少数几种可预测的呼吸道病原体有关。我们对细支气管炎与后续喘息之间关联的认识正处于不断演变的状态。细支气管炎很少会进展为慢性阻塞性病变，即闭塞性细支气管炎，最常见于腺病毒感染后。成人细支气管炎的诊断相对少见，尽管缺乏关于病原体的具体信息，但婴幼儿细支气管炎中涉及的感染病原体很可能在成人型疾病中也起作用。成人闭塞性细支气管炎可由多种可能原因引起，包括感染。虽然感染可能促成了器官移植后人群闭塞性细支气管炎的发病机制，但这个过程似乎是以移植排斥为中心的复杂相互作用。
