Thomson Merran A
Department of Paediatrics and Neonatal Medicine, Queen Charlotte's and Chelsea Hospital at the Hammersmith Hospital, London, UK.
Biol Neonate. 2002;81 Suppl 1:16-9. doi: 10.1159/000056766.
Bronchopulmonary dysplasia (BPD) remains a cause of considerable morbidity for the preterm infant. Ventilation is a primary risk factor. This review discusses the rationale for combining surfactant and nasal continuous positive airway pressure (nCPAP) using evidence from both clinical and animal studies. The early application of nCPAP with or without surfactant is safe and reduces the need for mechanical ventilation. Combining nCPAP with surfactant results in dramatically improved lung structure in a primate model of BPD, but still does not allow for normal alveolarization. BPD is a complex condition resulting from the interaction of many factors. Experimental evaluation of nCPAP in appropriate animal models will allow new strategies for prevention and treatment of BPD to be developed.
支气管肺发育不良（BPD）仍然是早产婴儿发病的一个重要原因。通气是主要危险因素。本综述利用临床和动物研究的证据，讨论了联合使用表面活性剂和经鼻持续气道正压通气（nCPAP）的理论依据。早期应用nCPAP（无论是否联合表面活性剂）是安全的，且可减少机械通气的需求。在BPD灵长类动物模型中，将nCPAP与表面活性剂联合使用可显著改善肺结构，但仍无法实现正常的肺泡化。BPD是由多种因素相互作用导致的复杂病症。在合适的动物模型中对nCPAP进行实验评估，将有助于开发预防和治疗BPD的新策略。
