呼吸系统相关疾病流行前后儿童呼吸道合胞 病毒诊疗进展
Advancements in Pediatric Respiratory Syncytial Virus Diagnosis and Treatment before and after the Respiratory Disease Pandemic
DOI: 10.12677/acm.2026.1641432, PDF,   
作者: 郑世凤, 闫 莉*：重庆医科大学附属儿童医院呼吸科，重庆；国家儿童健康与疾病临床医学研究中心，重庆；儿童发育疾病研究教育部重点实验室，重庆；儿童发育重大疾病国家国际科技合作基地，重庆；儿科学重庆市重点实验室，重庆
关键词: 呼吸系统相关疾病大流行；呼吸道合胞病毒；流行病学；免疫预防；Pandemic of Respiratory Diseases； Respiratory Syncytial Virus； Epidemiology； Immunoprophylaxis
摘要: 呼吸系统相关疾病大流行重塑了全球公共卫生格局，并对儿童呼吸道合胞病毒(RSV)的流行病学、检测技术、治疗策略及预防管理产生了直接或间接的影响。本综述系统整合最新循证证据，揭示了流行前后儿童RSV流行呈现的“消失–延迟–超量反弹”三阶段。同时，呼吸系统相关疾病大流行推动了多重呼吸道病毒PCR及宏基因组测序的广泛应用。目前RSV治疗仍以支持治疗为主导，但高流量鼻导管氧疗与无创通气使用上升、有创机械通气需求下降，提示呼吸支持策略持续优化。RSV预防实现了从“小众高危保护”到“普遍覆盖防护”的跨越。然而当前仍面临免疫债消退规律的动态演变尚待量化、长效抗体对婴幼儿免疫发育的长期影响尚需评估、mRNA疫苗安全性需进一步验证，且中低收入国家的预防可及性等挑战。本文系统梳理呼吸系统相关疾病大流行对儿童RSV感染在流行病学、检测、治疗及预防策略的影响，为理解RSV防控的代际演进及后续呼吸道病毒感染的精准防控提供理论框架与科学依据。
Abstract: The respiratory disease pandemic has reshaped global public health, directly and indirectly impacting pediatric Respiratory Syncytial Virus (RSV) epidemiology, detection, treatment, and prevention. This review synthesizes recent evidence, revealing a three-phase pattern in pediatric RSV epidemics before and after the pandemic: “disappearance, delay, and rebound surge.” The pandemic accelerated the adoption of multiplex PCR and metagenomic sequencing. Currently, RSV treatment remains primarily supportive, but trends in respiratory support—increased use of high-flow nasal cannula and non-invasive ventilation, decreased invasive mechanical ventilation—indicate evolving strategies. RSV prevention has advanced from targeted protection for high-risk groups to universal coverage. However, challenges persist: quantifying immunity debt dynamics, assessing long-term effects of long-acting antibodies on infant immune development, verifying mRNA vaccine safety, and improving access in low- and middle-income countries. This review systematically examines the pandemic’s impact on pediatric RSV infection across epidemiology, detection, treatment, and prevention, providing a scientific framework for understanding RSV control evolution and precise management of subsequent respiratory viral infections.
文章引用：郑世凤, 闫莉. 呼吸系统相关疾病流行前后儿童呼吸道合胞 病毒诊疗进展 [J]. 临床医学进展, 2026, 16(4): 1908-1915. https://doi.org/10.12677/acm.2026.1641432

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