小结
定义
呼吸道合胞病毒（respiratory syncytial virus, RSV）属肺病毒科。它是细支气管炎的最常见病因。
细支气管炎症状包括鼻溢、咳嗽、喘息、呼吸窘迫和低氧血症。[1] RSV 还可导致儿童肺炎，在少数情况下，甚至使免疫功能正常的成人患上肺炎。[Figure caption and citation for the preceding image starts]: 显示 RSV 形态学特征的电子显微照片CDC/Palmer EL；经获准使用 [Citation ends].
病史和体格检查
关键诊断因素
- 存在的危险因素
- RSV 暴露
- 具有 RSV 感染高风险的婴儿
- 老人
- 冬季
- 免疫缺陷
- 流涕/鼻塞
- 呼吸急促
- 呼吸功增加
- 咳嗽
- 喘鸣
- 饮食不佳
- 发绀
- 啰音
- 呼吸暂停
其他诊断因素
- 发热
危险因素
- RSV 暴露
- 有血流动力学意义的先天性心脏病
- 早产史
- 免疫缺陷
- 慢性肺疾病
- 近期未针对 RSV 进行免疫预防的高风险婴儿
- 6 月龄以下婴儿
- 冬季
- 老人
- 烟雾暴露
- 哮喘家族史
- 唐氏综合征
诊断性检查
首要检查
- 脉搏血氧测量测定法
需考虑的检查
- 胸部 X 线检查
- 水合状态
- 呼吸道采样（例如鼻咽吸出物）进行直接荧光抗体染色
- 对呼吸道样本（例如鼻咽吸出物）进行逆转录聚合酶链反应检测
- 呼吸道样本的病毒培养（例如，鼻咽抽吸物）
治疗流程
轻度或自限性疾病
中度疾病
严重疾病
撰稿人
作者
Giovanni Piedimonte, MD, FAAP, FCCP
Vice President for Research
Professor of Pediatrics, Biochemistry & Molecular Biology
Tulane University School of Medicine
New Orleans
LA
利益声明
GP declares that he has no competing interests.
Margot Anderson, MD
Assistant Professor of Clinical Pediatrics
Section of Infectious Diseases and Hospital Medicine
Tulane University School of Medicine
Tulane University
New Orleans
LA
利益声明
MA will be the principal investigator for a phase 3 trial to evaluate the safety, efficacy, and pharmacokinetics of MK-1654 in infants and children at increased risk for severe respiratory syncytial virus disease, based at Tulane University School of Medicine. Merck will reimburse Tulane University for participation.
鸣谢
Dr Giovanni Piedimonte and Dr Margot Anderson would like to gratefully acknowledge Dr Frank Esper and Dr Melvin L. Wright, previous contributors to this topic.
利益声明
FE is on an advisory board for Procter and Gamble. MLW declares that he has no competing interests.
同行评议者
Leonard R. Krilov, MD
Chief
Pediatric Infectious Disease
Vice Chairman
Department of Pediatrics
Children's Medical Center
Winthrop University Medical Center
Mineola
Professor of Pediatrics
School of Medicine
Stony Brook University Medical Center
Stony Brook
NY
利益声明
LRK has participated as an investigator in multiple clinical research trials supported by grants from MedImmune. LRK has also served as a consultant to MedImmune on medical advisory boards and is a member of their speakers' bureau.
Robert Welliver, MD
Professor of Pediatrics
Women and Children's Hospital
Buffalo
NY
利益声明
RW declares that he has no competing interests.
Jennifer Handforth, MB ChB, MRCPCH, DTM&H
Consultant Paediatrician
Croydon University Hospital
Croydon
UK
利益声明
JH declares that she has no competing interests.
鉴别诊断
- 人偏肺病毒
- 流感病毒
- 副流感病毒
更多 鉴别诊断指南
- 儿童毛细支气管炎：诊断和管理
- 澳大利亚细支气管炎指南
更多 指南患者教育信息
毛细支气管炎
儿童哮喘：是什么？
更多 患者教育信息
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