改善支气管肺发育不良的早期诊断。

Expert review of respiratory medicine Pub Date : 2024-05-01 Epub Date: 2024-06-14 DOI:10.1080/17476348.2024.2367584
Oishi Sikdar, Christopher Harris, Anne Greenough
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引用次数: 0

摘要

简介:支气管肺疾病(BPD)与长期的神经发育和心肺并发症有关,通常需要大量资源。为了减轻这一医疗负担,必须及早发现支气管肺疾病的高危人群,从而采取相应策略防止疾病恶化。我们的目的是讨论改善出生后第一周早期诊断的潜在方法:进行了叙述性综述。检索策略包括检索 1967 年至 2024 年的 PubMed、Embase 和 Cochrane 数据库。讨论了潜在生物标志物和成像模式的结果。此外,还探讨了评分系统的价值:BPD的发生是肺血管和肺泡发育受到破坏的结果,因此调节这些过程的因子水平异常是探索早期发现高危婴儿的可行途径。双生子研究的数据表明,在中度至重度 BPD 观察到的差异中,82% 可归因于遗传因素,但大型全基因组研究的结果却相互矛盾。需要进行比较研究,以确定哪种生物标志物或成像模式可最准确地诊断早期 BPD 的发展。今后应评估包含最多预测因素的模型。
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Improving early diagnosis of bronchopulmonary dysplasia.

Introduction: Bronchopulmonary disease (BPD) is associated with long-term neurodevelopmental and cardiorespiratory complications, often requiring significant use of resources. To reduce this healthcare burden, it is essential that those at high risk of BPD are identified early so that strategies are introduced to prevent disease progression. Our aim was to discuss potential methods for improving early diagnosis in the first week after birth.

Areas covered: A narrative review was undertaken. The search strategy involved searching PubMed, Embase and Cochrane databases from 1967 to 2024. The results of potential biomarkers and imaging modes are discussed. Furthermore, the value of scoring systems is explored.

Expert opinion: BPD occurs as a result of disruption to pulmonary vascular and alveolar development, thus abnormal levels of factors regulating those processes are promising avenues to explore with regard to early detection of high-risk infants. Data from twin studies suggests genetic factors can be attributed to 82% of the observed difference in moderate to severe BPD, but large genome-wide studies have yielded conflicting results. Comparative studies are required to determine which biomarker or imaging mode may most accurately diagnose early BPD development. Models which include the most predictive factors should be evaluated going forward.

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