摘要
研究背景:血液动力学显著改变的先天性心脏病(CHD)是幼儿重度呼吸道合胞病毒(RSV)性疾病的危险因素之一。要评估使用呼吸道合胞病毒单抗体palivizumab进行RSV免疫预防的潜在功效,需要获得CHD患者RSV住院率的群体数据。目的:①获取24个月龄以下CHD患儿RSV住院率的群体资料。②将CHD 患儿的结果与非CHD患儿以及既往研究结果进行对照研究。
Background: Haemodynamically significant congenital heart disease (CHD) is a risk factor for severe respiratory syncytial virus (RSV) disease in young children. Population based data on the incidence of RSV hospitalisations in CHD patients are needed to estimate the potential useful- ness of RSV immunoprophylaxis using palivizumab. Aims: (1) To obtain population based RSV hospitalisation rates in children < 24 months of age with CHD. (2) To compare these rates with non-CHD patients and with previous studies. (3) To determine the number of patients needed to treat (NNT) with palivizumab to prevent one RSV hospitalisation. Methods: Six year, longitudinal, population based study at an institution, which is the sole provider of primary to tertiary in-patient care for a precisely defined paediatric population. Results: RSV hospitalisation rates (per 100 child-years) in CHD patients aged < 6, < 12, 12-24, and < 24 months of age were 2. 5 (95% Cl 0. 8 to 5.6), 2.0 (0.8 to 3. 8), 0.5 (0. 1 to 1. 8), and 1. 3 (0. 6 to 2. 3), respectively, and the relative risk (RR) in comparison with non-CHD patients was 1. 4 (0. 6 to 3. 1), 1.6 (0.8 to 3.2), 2.7 (0.7 to 9.7), and 1.8 (1.0 to 3. 3), respectively. NNT was between 80 (35 to 245) and 259 (72 to 2140) for various age groups. Conclusion: RSV hospitalisation rates in CHD patients were fourfold lower than reported from the USA. Based on these low rates and RR, unrestricted use of palivizumab does not appear to be justified in this study area.
