Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK.
Thorax. 2013 Aug;68(8):760-6. doi: 10.1136/thoraxjnl-2012-203079. Epub 2013 Apr 20.
Increasing evidence suggests that preterm birth affects later lung function. We systematically reviewed the literature to determine whether percentage predicted forced expiratory volume in 1 s (%FEV1) is lower in later life in preterm-born subjects, with or without bronchopulmonary dysplasia (BPD), compared with term-born controls.
Studies reporting %FEV1, with or without a term-born control group, in later life for preterm-born subjects (<37 weeks gestation) were extracted from eight databases. Data were analysed using Review Manager and STATA. The quality of the studies was assessed.
From 8839 titles, 1124 full articles were screened and 59 were included: 28 studied preterm-born children without BPD, 24 with BPD28 (supplemental oxygen dependency at 28 days), 15 with BPD36 (supplemental oxygen dependency 36 weeks postmenstrual age) and 34 born preterm. For the preterm-born group without BPD and for the BPD28 and BPD36 groups the mean differences (and 95% CIs) for %FEV1 compared with term-born controls were -7.2% (-8.7% to -5.6%), -16.2% (-19.9% to -12.4%) and -18.9% (-21.1% to -16.7%), respectively. Pooling all data on preterm-born subjects whether or not there was a control group gave a pooled %FEV1 estimate of 91.0% (88.8% to 93.1%) for the preterm-born cohort without BPD, 83.7% (80.2% to 87.2%) for BPD28 and 79.1% (76.9% to 81.3%) for BPD36. Interestingly, %FEV1 for BPD28 has improved over the years.
%FEV1 is decreased in preterm-born survivors, even those who do not develop BPD. %FEV1 of survivors of BPD28 has improved over recent years. Long-term respiratory follow-up of preterm-born survivors is required as they may be at risk of developing chronic obstructive pulmonary disease.
越来越多的证据表明，早产会影响以后的肺功能。我们系统地回顾了文献，以确定在没有或有支气管肺发育不良（BPD）的情况下，与足月出生的对照组相比，早产儿在以后的生活中 1 秒用力呼气量百分比（%FEV1）是否较低。
从八个数据库中提取了报告早产儿（<37 周妊娠）以后生活中 %FEV1 的研究，无论是否有足月出生的对照组。使用 Review Manager 和 STATA 分析数据。评估了研究的质量。
从 8839 个标题中，筛选出 1124 篇全文，其中 59 篇被纳入：28 篇研究了没有 BPD 的早产儿，24 篇研究了 BPD28（28 天需要补充氧气），15 篇研究了 BPD36（出生后 36 周需要补充氧气），34 篇研究了早产儿。对于没有 BPD 的早产儿组和 BPD28 组和 BPD36 组，与足月出生的对照组相比，%FEV1 的平均差异（95%CI）分别为-7.2%（-8.7%至-5.6%）、-16.2%（-19.9%至-12.4%）和-18.9%（-21.1%至-16.7%）。汇总所有有或没有对照组的早产儿数据，得出无 BPD 的早产儿队列的汇总%FEV1 估计值为 91.0%（88.8%至 93.1%），BPD28 为 83.7%（80.2%至 87.2%），BPD36 为 79.1%（76.9%至 81.3%）。有趣的是，BPD28 的 %FEV1 近年来有所改善。
即使没有发展为 BPD，早产儿幸存者的 %FEV1 也会降低。BPD28 幸存者的 %FEV1 近年来有所提高。需要对早产儿幸存者进行长期的呼吸随访，因为他们可能有患慢性阻塞性肺疾病的风险。
