Baker Christopher D, Abman Steven H, Mourani Peter M
Section of Pulmonary Medicine, University of Colorado School of Medicine , Aurora, Colarado. ; Pediatric Heart Lung Center, University of Colorado School of Medicine , Aurora, Colarado.
Pediatric Heart Lung Center, University of Colorado School of Medicine , Aurora, Colarado. ; Section of Critical Care Medicine, Department of Pediatrics, University of Colorado School of Medicine , Aurora, Colarado.
Pediatr Allergy Immunol Pulmonol. 2014 Mar 1;27(1):8-16. doi: 10.1089/ped.2013.0323.
Bronchopulmonary dysplasia (BPD), the chronic lung disease of prematurity, is a significant contributor to perinatal morbidity and mortality. Premature birth disrupts pulmonary vascular growth and initiates a cascade of events that result in impaired gas exchange, abnormal vasoreactivity, and pulmonary vascular remodeling that may ultimately lead to pulmonary hypertension (PH). Even infants who appear to have mild BPD suffer from varying degrees of pulmonary vascular disease (PVD). Although recent studies have enhanced our understanding of the pathobiology of PVD and PH in BPD, much remains unknown with respect to how PH should be properly defined, as well as the most accurate methods for the diagnosis and treatment of PH in infants with BPD. This article will provide neonatologists and primary care providers, as well as pediatric cardiologists and pulmonologists, with a review of the pathophysiology of PH in preterm infants with BPD and a summary of current clinical recommendations for managing PH in this population.
支气管肺发育不良（BPD）是一种早产慢性肺病，是围产期发病和死亡的重要原因。早产会破坏肺血管生长，并引发一系列事件，导致气体交换受损、血管反应性异常和肺血管重塑，最终可能导致肺动脉高压（PH）。即使是看似患有轻度BPD的婴儿也存在不同程度的肺血管疾病（PVD）。尽管最近的研究增进了我们对BPD中PVD和PH病理生物学的理解，但关于如何正确定义PH以及诊断和治疗BPD婴儿PH的最准确方法仍有很多未知之处。本文将为新生儿科医生、初级保健提供者以及儿科心脏病学家和肺科医生提供有关BPD早产儿PH病理生理学的综述，以及该人群中管理PH的当前临床建议总结。
