呼吸道合胞病毒感染

已经充分证明，严重 RSV 感染与之后出现喘息相关。因 RSV 毛细支气管炎而需要住院的婴儿，在之后长达 10 年内发生肺功能异常和复发性喘息的风险更高。[96]Mok JY, Simpson H. Outcome for acute bronchitis, bronchiolitis, and pneumonia in infancy. Arch Dis Child. 1984 Apr;59(4):306-9.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1628672/http://www.ncbi.nlm.nih.gov/pubmed/6721555?tool=bestpractice.com[97]Murray M, Webb MS, O'Callaghan C, et al. Respiratory status and allergy after bronchiolitis. Arch Dis Child. 1992 Apr;67(4):482-7.http://www.ncbi.nlm.nih.gov/pubmed/1580676?tool=bestpractice.com[98]Noble V, Murray M, Webb MS, et al. Respiratory status and allergy nine to 10 years after acute bronchiolitis. Arch Dis Child. 1997 Apr;76(4):315-9.http://adc.bmj.com/content/76/4/315.longhttp://www.ncbi.nlm.nih.gov/pubmed/9166022?tool=bestpractice.com[99]Osundwa VM, Dawod ST, Ehlayel M. Recurrent wheezing in children with respiratory syncytial virus (RSV) bronchiolitis in Qatar. Eur J Pediatr. 1993 Dec;152(12):1001-3.http://www.ncbi.nlm.nih.gov/pubmed/8131799?tool=bestpractice.com[100]Sims DG, Downham MA, Gardner PS, et al. Study of 8-year-old children with a history of respiratory syncytial virus bronchiolitis in infancy. Br Med J. 1978 Jan 7;1(6104):11-14.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1602461/http://www.ncbi.nlm.nih.gov/pubmed/620129?tool=bestpractice.com[145]McConnochie KM, Roghmann KJ. Bronchiolitis as a possible cause of wheezing in childhood: new evidence. Pediatrics. 1984 Jul;74(1):1-10.http://www.ncbi.nlm.nih.gov/pubmed/6739202?tool=bestpractice.com

关于严重 RSV 感染是否是哮喘的危险因素，抑或仅仅是一种易感标志，仍然存在争议。几项研究支持二者间存在关联或因果联系。[95]Sigurs N, Bjarnason R, Sigurbergsson F, et al. Respiratory syncytial virus bronchiolitis in infancy is an important risk factor for asthma and allergy at age 7. Am J Respir Crit Care Med. 2000 May;161(5):1501-7.http://www.atsjournals.org/doi/full/10.1164/ajrccm.161.5.9906076#.UlQowlPCZgAhttp://www.ncbi.nlm.nih.gov/pubmed/10806145?tool=bestpractice.com[146]Stein RT, Sherrill D, Morgan WJ, et al. Respiratory syncytial virus in early life and risk of wheeze and allergy by age 13 years. Lancet. 1999 Aug 14;354(9178):541-5.http://www.ncbi.nlm.nih.gov/pubmed/10470697?tool=bestpractice.com[147]Lu S, Hartert TV, Everard ML, et al. Predictors of asthma following severe respiratory syncytial virus (RSV) bronchiolitis in early childhood. Pediatr Pulmonol. 2016 Dec;51(12):1382-92.http://www.ncbi.nlm.nih.gov/pubmed/27152482?tool=bestpractice.com然而，一项随机对照试验将接受帕利珠单抗治疗预防 RSV 感染的婴儿与未接受帕利珠单抗预防性治疗的婴儿进行了比较，结果显示，6 岁时诊断为哮喘或肺功能改变的婴儿数量没有显著差异。[148]Scheltema NM, Nibbelke EE, Pouw J, et al. Respiratory syncytial virus prevention and asthma in healthy preterm infants: a randomised controlled trial. Lancet Respir Med. 2018 Apr;6(4):257-64.http://www.ncbi.nlm.nih.gov/pubmed/29500030?tool=bestpractice.com

Asthma in children

RSV 细支气管炎可能造成严重的呼吸窘迫。 高风险婴儿（例如早产儿或有慢性肺疾病、复杂型先天性心脏病或免疫功能受损的婴儿）在就诊时可能病情更严重。 呼吸暂停是常见并发症，尤其是对于小婴儿，并且可能是主要表现。

Bronchiolitis

RSV 可导致儿童或免疫功能正常的成人（很罕见）患上肺炎。 RSV 肺炎通常会出现低热、持续咳嗽和全身乏力等症状。

Overview of pneumonia