Lung function in prematurely born infants after viral lower respiratory tract infections
Lung function in prematurely born infants after viral lower respiratory tract infections
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DOI：
10.1097/inf.0b013e318126bbb9
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发表时间：
2007-11-01
影响因子：
3.6
通讯作者：
Greenough, Anne
中科院分区：
文献类型：
--
作者：
Broughton, Simon;Sylvester, Karl P.;Greenough, Anne
背景：呼吸道合胞病毒（RSV）和人偏肺病毒（hMPV）下呼吸道感染（LRTIs）后早产儿出现慢性呼吸道疾病的报道。本研究的目的是确定病毒性下呼吸道感染对早产儿随访时肺功能的影响。方法：对59例32周前出生的新生儿出院后进行前瞻性随访。当婴儿在医院或社区发生下呼吸道感染时，进行鼻咽吸痰。RSV通过免疫荧光和/或培养进行鉴定。采用实时逆转录聚合酶链反应鉴定RSV等病毒感染。在校正年龄为1岁时，通过体积描记术测量肺体积[功能剩余容量（FRC）（pleth）]和气道阻力（R-aw），并通过氦气稀释（FRCHe）评估肺体积。在测量之前，父母完成了一个月的日记卡，每天记录他们的婴儿是否喘息、咳嗽或需要支气管扩张剂治疗。结果：25例患儿至少有1例经证实的RSV LRTI （RSV阳性组）。rsv阳性组与其他组相比肺容量相似，但R-aw明显较高（P = 0.002），喘息天数更长（P < 0.001）。支气管扩张剂需要量（P = 0.027）。回归分析还发现hMPV LRTI与随访时气道阻力升高有关。结论：RSV和hMPV型早产儿下呼吸道感染与随访时肺功能异常有关。
Background: Chronic respiratory morbidity has been reported in prematurely born infants after respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) lower respiratory tract infections (LRTIs). The aim of this study was to determine the impact of viral LRTI on lung function at follow-up of prematurely born infants.Methods: Fifty-nine infants born before 32 weeks of gestational age were prospectively followed after neonatal unit discharge. Nasopharyngeal aspirates were obtained when the infants developed LRTIs in hospital or the community. RSV was identified by immunofluorescence and/or culture. In addition, RSV and other viral infections were identified by real time reverse transcription polymerase chain reaction. At a corrected age of 1 year, measurements of lung volume [functional residual capacity (FRC)(pleth)] and airway resistance (R-aw) were made by plethysmography, and lung volume was also assessed by helium gas dilution (FRCHe). Before the measurements, parents completed diary cards for I month documenting on a daily basis whether their infant wheezed, coughed, or required bronchodilator therapy.Results: Twenty-five infants had at least 1 proven RSV LRTI (RSV-positive group). The RSV-positive group compared with the rest of the cohort had similar lung volumes, but significantly higher R-aw (P = 0.002), more days of wheeze (P < 0.001). and bronchodilator requirement (P = 0.027). Regression analysis also identified that hMPV LRTI was associated with elevated airways resistance at follow-up.Conclusion: RSV and hMPV LRTIs in prematurely born infants are associated with abnormal lung function at follow-up.