儿童副流感病毒感染研究进展

doi:10.3877/cma.j.issn.1674-1358.2022.05.002

人副流感病毒（HPIVs）是引起儿童急性上、下呼吸道感染的一种重要病毒，属于副黏病毒科，分为4个亚型（HPIV1~4），其中HPIV1、2多在秋季流行，是导致儿童喉炎的主要病原体；HPIV3于春季、秋季均可流行，可导致新生儿及婴儿毛细支气管炎、肺炎；HPIV4感染多症状轻微，占比较低，相关数据较少。在全球范围内，HPIV是引起儿童喉炎、气管支气管炎、毛细支气管炎和肺炎等急性呼吸道感染疾病的常见病原，因其感染就诊、住院人数众多，且导致免疫功能低下人群病重、病死率增加，造成了沉重的疾病负担。HPIV感染的确诊依赖病原学检测，其中核酸检测灵敏度、特异度高，目前在临床应用范围越来越广。虽然目前尚无针对该病毒的特效药物，但重组神经氨酸酶融合蛋白DAS181，以及神经氨酸酶抑制剂BCX2798和BCX2855的相关研究不断进展。另外，针对HPIV的多种疫苗目前已进入了临床试验阶段。本综述总结HPIV感染的病毒学特征、流行病学特征、临床表现、诊断及治疗，以及疫苗方面的相关内容及研究进展，以供临床医师参考。

关键词: 人副流感病毒, 儿科

Human parainfluenza viruses (HPIVs) are important viruses which cause acute upper and lower respiratory tract infections in children. They belong to the Paramyxoviridae family and are divided into four subtypes (HPIV1-4). HPIV1 and HPIV2, which are mainly prevalent in autumn, are the main cause of laryngitis in children. HPIV3 causes epidemic in spring and autumn, often causing neonatal and infant bronchiolitis and pneumonia. Symptoms of HPIV4 infection are mostly mild, accounting for a relatively low proportion of the relevant data. Globally, HPIVs are common causes of acute respiratory tract infections in children, such as laryngitis, tracheobronchitis, bronchiolitis, pneumonia and so on. Heavy disease burden was resulted from the large numbers of outpatients and inpatients, as well as the high rates of severity and fatality among immunocompromised. The diagnosis depends on the pathogen detection, among which nupopulationcleic acid detection has high sensitivity and specificity, and is now being used more and more widely in clinical applications. Although there is no specific drug for the virus at present, studies on recombinant neuraminidase fusion protein DAS181, and neuraminidase inhibitors BCX2798 and BCX2855 are progressing. Breakthroughs on the treatment of the virus will be completed in the near future. In addition, several vaccines against HPIVs are currently in clinical trials. In this review, the virology, epidemiology, clinical manifestations, diagnosis, treatment, and vaccines of human parainfluenza viruses are summarized for clinical reference.

Key words: Human parainfluenza viruses, Pediatrics

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