Greenough Anne
Division of Asthma, Allergy and Lung Biology, King's College London School of Medicine at Guy's, St Thomas' Hospitals, London, UK.
Neonatology. 2008;93(4):324-7. doi: 10.1159/000121459. Epub 2008 Jun 5.
Chronic respiratory morbidity is common following premature birth, particularly if complicated by the development of bronchopulmonary dysplasia (BPD). Affected infants can remain oxygen dependent for many months and frequently require hospital readmission in the first 2 years after birth. Troublesome, recurrent respiratory symptoms requiring treatment are common in prematurely born children, especially those who had BPD. The most severely affected may remain symptomatic and have evidence of airway obstruction even as adults. The studies examining adolescents and adults usually report patients who had 'classical' BPD, that is they often had had severe respiratory failure in the neonatal period with chronic pulmonary fibrosis and airway smooth muscle hypertrophy. Nowadays, infants are described as having 'new' BPD, developing chronic oxygen dependence despite initially minimal or even no respiratory distress. Affected patients, however, have reduced alveolarisation and experience deterioration in lung function over the 1st year after birth. It is essential to determine if they have 'catch up' and identify which strategies impair and most importantly promote lung growth in this very-high-risk population.
早产之后慢性呼吸道疾病很常见,尤其是并发支气管肺发育不良(BPD)时。受影响的婴儿可能在数月内一直依赖氧气,并且在出生后的头两年经常需要再次住院。早产儿童中,需要治疗的麻烦的反复呼吸道症状很常见,尤其是那些患有BPD的儿童。受影响最严重的儿童即使成年后可能仍有症状并有气道阻塞的迹象。针对青少年和成年人的研究通常报告的是患有“经典”BPD的患者,也就是说他们在新生儿期经常有严重的呼吸衰竭,并伴有慢性肺纤维化和气道平滑肌肥大。如今,婴儿被描述为患有“新型”BPD,尽管最初极少甚至没有呼吸窘迫,但仍会发展为慢性氧气依赖。然而,受影响的患者肺泡化减少,并且在出生后的第一年肺功能会恶化。确定他们是否“追赶上来”,并确定哪些策略会损害以及最重要的是促进这个极高风险人群的肺生长至关重要。