Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Section of Pediatrics, Stockholm, Sweden.
Respir Med. 2010 Mar;104(3):362-70. doi: 10.1016/j.rmed.2009.10.008. Epub 2009 Nov 10.
Bronchopulmonary dysplasia (BPD) is a common cause of respiratory insufficiency in children born very premature.
The purpose of this study was to examine the impact of the severity of BPD on pulmonary morbidity at school age, as measured by conventional spirometry and impulse oscillometry. We also studied the association between changes in lung function and structural changes in the lungs of children with BPD via High-Resolution Computed Tomography (HRCT). Finally we studied the prevalence of atopy associated with BPD.
We studied 60 very low birth weight (VLBW) children, 28 with respiratory distress syndrome (RDS) who did not develop BPD ("preterm non-BPD") and 32 with RDS who developed BPD. The severity of BPD was graded as mild, moderate or severe. Follow-up at age 6-8 years consisted of spirometry, oscillometry, thoracic HRCT, allergy skin-prick test, blood samples and a questionnaire.
All children with BPD showed some evidence of impaired lung function (more negative reactance, FEV1<80% predicted, greater reversibility), although less than half of these children were symptomatic. The majority of children with BPD (19/26) showed abnormalities on HRCT. There was no evidence that atopy was associated with BPD.
Children with mild BPD exhibited similar impairments in respiratory mechanics and lung structure to those diagnosed with moderate BPD. The widespread involvement of the peripheral airways suggests that all children diagnosed with BPD are potentially at risk of developing chronic obstructive pulmonary disease later in life.
支气管肺发育不良（BPD）是极早产儿呼吸功能不全的常见原因。
本研究旨在通过常规肺量计和脉冲振荡法评估 BPD 严重程度对儿童在校年龄肺部发病率的影响。我们还通过高分辨率计算机断层扫描（HRCT）研究了 BPD 患儿肺功能变化与肺部结构变化之间的关系。最后，我们研究了与 BPD 相关的特应性患病率。
我们研究了 60 名极低出生体重（VLBW）儿童，其中 28 名患有呼吸窘迫综合征（RDS）且未发生 BPD（“早产儿非 BPD”），32 名患有 RDS 且发生了 BPD。BPD 的严重程度分为轻度、中度或重度。6-8 岁时的随访包括肺量计、振荡法、胸部 HRCT、过敏皮肤点刺试验、血液样本和问卷调查。
所有患有 BPD 的儿童均表现出一定程度的肺功能受损（更多负反应、FEV1<80%预计值、更大的可逆性），尽管只有不到一半的儿童出现症状。大多数患有 BPD 的儿童（26 例中有 19 例）HRCT 检查异常。没有证据表明特应性与 BPD 相关。
轻度 BPD 患儿的呼吸力学和肺结构异常与中度 BPD 患儿相似。外周气道的广泛受累表明，所有诊断为 BPD 的儿童都有可能在以后的生活中发展为慢性阻塞性肺疾病。
