伴有或不伴有支气管肺发育不良的早产儿肺功能的发展——一项12岁时的随访研究

Cecilia Hagman, L. Björklund, L. Bjermer, I. Hansen-Pupp, E. Tufvesson
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引用次数: 1

摘要

非常早产后的肺部疾病可能导致永久性肺损伤,因此,长期存活者的肺功能受损,支气管肺发育不良是最早的表现之一。目的:本研究的目的是评估12岁非常早产儿童的肺功能,并与足月出生儿童进行比较。此外,我们还确定了BPD和儿童时期早产的影响。方法:98例胎龄22 ~ 31周(中位胎龄27周,出生体重950g)的患儿在12岁时进行肺活量测定、脉搏振荡测定、体体积描记仪和弥散能力测定。年龄匹配的足月出生儿童作为对照(n=17)。BPD的定义是在经后36周需要补充氧气。结果:早产与用力呼气流量(FEF25-75)降低有关,p=0.05;与总阻力(R5)和外周阻力(R5-20)升高有关,p=0.01;与弥散能力降低有关,p=0.01;与没有BPD的早产儿相比,患有BPD的早产儿在12岁时没有明显的肺功能损害。结论:早产与12岁时显著阻塞性气道疾病和肺功能损害的风险增加相关,与BPD诊断无关。早产儿将受益于定期评估肺功能,以了解整个青春期和成年期的长期后遗症和呼吸健康状况。
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Development of lung function in children born preterm with and without bronchopulmonary dysplasia - a follow-up study at 12 years of age
Introduction: Pulmonary disease after very preterm birth may cause permanent lung damage and as a consequence, lung function impairment in long-term survivors, bronchopulmonary dysplasia being one of the earliest manifestation. Aims: The aim of this study was to assess lung function in children 12 years of age, born very preterm and compare with children born at term. In addition we determined the impact of BPD and prematurity during childhood. Methods: Spirometry, impulse oscillometry, body plethysmograhy and diffusing capacity was performed at 12 years of age in 98 children, born at gestational age of 22-31 weeks (median 27 weeks and birth weight 950g). Age-matched children born at term were included as controls (n=17). BPD was defined as need for supplemental oxygen at 36 weeks postmenstrual age. Results: Prematurity was associated with lower forced expiratory flow (FEF25-75), p=0.05, higher total (R5) and peripheral (R5-20) resistance, p=0.01 resp p Prematurity was also associated with lower diffusion capacity, p=0.01 and higher residual volume, p=0.02. Preterm children with BPD showed no significant lung function impairment at the age of 12 compared to preterm children without BPD. Conclusion: Preterm birth is associated with an increased risk of significant obstructive airway disease and lung function impairment at the age of 12, regardless of BPD diagnosis. Children born preterm would benefit from regular assessment of lung function to give an insight regarding long-term sequele and respiratory health throughout adolescence and adulthood.
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