Northway W H, Moss R B, Carlisle K B, Parker B R, Popp R L, Pitlick P T, Eichler I, Lamm R L, Brown B W
Department of Diagnostic Radiology and Nuclear Medicine, Stanford University Medical Center, CA 94305.
N Engl J Med. 1990 Dec 27;323(26):1793-9. doi: 10.1056/NEJM199012273232603.
Bronchopulmonary dysplasia is a chronic lung disease that often develops after mechanical ventilation in prematurely born infants with respiratory failure. It has become the most common form of chronic lung disease in infants in the United States. The long-term outcome for infants with bronchopulmonary dysplasia has not been determined.
We studied the pulmonary function of 26 adolescents and young adults, born between 1964 and 1973, who had bronchopulmonary dysplasia in infancy. We compared the results with those in two control groups: 26 age-matched adolescents and young adults of similar birth weight and gestational age who had not undergone mechanical ventilation, and 53 age-matched normal subjects.
Sixty-eight percent of the subjects with bronchopulmonary dysplasia in infancy (17 of the 25 tested) had airway obstruction, including decreases in forced expiratory volume in one second, forced expiratory flow between 25 and 75 percent of vital capacity, and maximal expiratory flow velocity at 50 percent of vital capacity, as compared with both control groups (P less than 0.0001 for all comparisons). Twenty-four percent of the subjects with bronchopulmonary dysplasia in infancy had fixed airway obstruction, and 52 percent had reactive airway disease, as indicated by their responses to the administration of methacholine or a bronchodilator. Hyperinflation (an increased ratio of residual volume to total lung capacity) was more frequent in the subjects with a history of bronchopulmonary dysplasia than in either the matched cohort (P less than 0.0006) or the normal controls (P less than 0.0004). Six of the subjects who had bronchopulmonary dysplasia in infancy had severe pulmonary dysfunction or current symptoms of respiratory difficulty.
Most adolescents and young adults who had bronchopulmonary dysplasia in infancy have some degree of pulmonary dysfunction, consisting of airway obstruction, airway hyperreactivity, and hyperinflation. The clinical consequences of this dysfunction are not known.
支气管肺发育不良是一种慢性肺部疾病，常发生于患有呼吸衰竭的早产婴儿接受机械通气之后。它已成为美国婴儿中最常见的慢性肺部疾病形式。支气管肺发育不良婴儿的长期预后尚未确定。
我们研究了1964年至1973年间出生、婴儿期患有支气管肺发育不良的26名青少年和青年成人的肺功能。我们将结果与两个对照组进行了比较：26名年龄匹配、出生体重和胎龄相似且未接受机械通气的青少年和青年成人，以及53名年龄匹配的正常受试者。
婴儿期患有支气管肺发育不良的受试者中，68%（25名接受测试者中的17名）存在气道阻塞，与两个对照组相比，一秒用力呼气容积、肺活量25%至75%之间的用力呼气流量以及肺活量50%时的最大呼气流速均降低（所有比较的P值均小于0.0001）。婴儿期患有支气管肺发育不良的受试者中，24%存在固定性气道阻塞，52%存在反应性气道疾病，这可通过他们对给予乙酰甲胆碱或支气管扩张剂的反应来表明。有支气管肺发育不良病史的受试者中，肺过度充气（残气量与肺总量之比增加）比匹配队列（P值小于0.0006）或正常对照组（P值小于0.0004）更为常见。婴儿期患有支气管肺发育不良的6名受试者存在严重的肺功能障碍或目前有呼吸困难症状。
大多数婴儿期患有支气管肺发育不良的青少年和青年成人存在一定程度的肺功能障碍，包括气道阻塞、气道高反应性和肺过度充气。这种功能障碍的临床后果尚不清楚。
