Hjalmarson Ola, Sandberg Kenneth
Department of Pediatrics, Göteborg University, Göteborg, Sweden.
Am J Respir Crit Care Med. 2002 Jan 1;165(1):83-7. doi: 10.1164/ajrccm.165.1.2107093.
The aim of this study was to assess the consequences of preterm birth for the functional development of the lungs. We studied 32 healthy preterm infants (gestational age 25 to 33 wk at birth) and 53 healthy full-term infants (37 to 42 wk) at the same mean postmenstrual age of 40 wk with a multibreath nitrogen washout technique to assess functional residual capacity (FRC), gas mixing efficiency, and dead space and with the single-breath occlusion technique to calculate compliance and resistance of the respiratory system. Twenty of the preterm infants were also assessed with the same methods at 34.2 (32 to 37) wk. At the same postmenstrual age the preterm infants had lower FRC/kg body weight, lower specific compliance, impaired gas mixing efficiency, and higher total and dead space ventilation/kg than the full-term infants. Specific compliance and specific conductance decreased but gas mixing efficiency increased from 34 to 40 wk. We conclude that premature exposure to extrauterine conditions changes lung function. Preterm infants showed signs of dysfunction of the terminal respiratory units and higher elastic recoil than infants who spent the corresponding time for development in utero. It is suggested that preterm birth per se affects alveolarization and formation of elastic tissue in the lungs.
本研究的目的是评估早产对肺功能发育的影响。我们采用多呼吸氮冲洗技术评估功能残气量（FRC）、气体混合效率和死腔，并采用单次呼吸阻断技术计算呼吸系统的顺应性和阻力，研究了32名健康早产儿（出生时胎龄25至33周）和53名健康足月儿（37至42周），这些婴儿在相同的平均孕龄40周时进行评估。其中20名早产儿在34.2（32至37）周时也采用相同方法进行了评估。在相同的孕龄时，早产儿的FRC/体重低于足月儿，比顺应性更低，气体混合效率受损，每千克体重的总通气量和死腔通气量更高。比顺应性和比传导率降低，但气体混合效率从34周增加到40周。我们得出结论，过早暴露于宫外环境会改变肺功能。与在子宫内度过相应发育时间的婴儿相比，早产儿表现出终末呼吸单位功能障碍的迹象和更高的弹性回缩力。提示早产本身会影响肺内肺泡化和弹性组织的形成。
