Fortuna Manuela, Carraro Silvia, Temporin Eva, Berardi Mariangela, Zanconato Stefania, Salvadori Sabrina, Lago Paola, Frigo Anna Chiara, Filippone Marco, Baraldi Eugenio
Department of Women's and Children's Health, University of Padova, Padova, Italy.
Department of Cardiac, Thoracic and Vascular Sciences, Biostatistics, Epidemiology and Public Health Unit, University of Padova, Padova, Italy.
Pediatr Pulmonol. 2016 Oct;51(10):1057-1064. doi: 10.1002/ppul.23422. Epub 2016 Apr 13.
Recent advances in perinatal care and neonatal respiratory therapy have led to a new phenotype of bronchopulmonary dysplasia ("new BPD"). The long-term respiratory outcome of this new form of BPD has yet to be adequately described. Aim of this study was to provide longitudinal data on lung function of an unselected cohort of children born extremely premature (EP) with an extremely low birth weight in the post-surfactant era.
Respiratory function was assessed twice (at 8 and 12 years) in 48 children born at a gestational age <28 weeks with a birth weight <1,000 g. Twenty-eight of them had BPD (oxygen-dependency at 36 weeks postmenstrual age) (EP-BPD), and 20 not (EP non-BPD). Twenty-seven children born at term served as control group.
The EP-BPD group had significantly lower spirometric values (given as z-scores) than controls, especially in parameters indicating airflow obstruction (8 ys: zFEV1:-1.3 ± 1 vs. 0.5 ± 0.8; 12 ys:-1.6 ± 1 vs. 0.5 ± 0.8, P < 0.001). Despite their better spirometric profile, EP-non-BPD children also had significantly lower parameters than controls (8ys: zFEV1:-0.5 ± 0.8; 12 ys:-0.5 ± 0.9, P < 0.001). During the 4-year follow-up, EP-non-BPD and controls had stable mean z-scores, but EP-BPD had a significant decline in mean zFEV1 (from -1.3 ± 1 to -1.6 ± 1, P = 0.03), zFEV1/FVC (from -0.4 ± 1 to -1.1 ± 1, P = 0.008), and zFEF 25-75% (from -1.2 ± 1 to -1.8 ± 1, P = 0.03).
EP children born in the post-surfactant era showed a significant airflow limitation, particularly pronounced in BPD subjects who in addition, presented an abnormal airway growth trajectory with a decline in lung function between the ages of 8 and 12 years. Pediatr Pulmonol. 2016;51:1057-1064. © 2016 Wiley Periodicals, Inc.
围产期护理和新生儿呼吸治疗的最新进展导致了支气管肺发育不良的一种新表型（“新型支气管肺发育不良”）。这种新型支气管肺发育不良的长期呼吸结局尚未得到充分描述。本研究的目的是提供关于表面活性剂时代后出生的极低出生体重的极早产儿非选择性队列肺功能的纵向数据。
对48名孕龄<28周、出生体重<1000g的儿童进行了两次呼吸功能评估（8岁和12岁时）。其中28名患有支气管肺发育不良（孕龄36周时需氧）（极早产支气管肺发育不良），20名未患（极早产非支气管肺发育不良）。27名足月儿作为对照组。
极早产支气管肺发育不良组的肺量计值（以z评分表示）显著低于对照组，尤其是在表明气流阻塞的参数方面（8岁时：zFEV1：-1.3±1对0.5±0.8；12岁时：-1.6±1对0.5±0.8，P<0.001）。尽管极早产非支气管肺发育不良儿童的肺量计指标较好，但他们的参数也显著低于对照组（8岁时：zFEV1：-0.5±0.8；12岁时：-0.5±0.9，P<0.001）。在4年的随访期间，极早产非支气管肺发育不良组和对照组的平均z评分稳定，但极早产支气管肺发育不良组的平均zFEV1（从-1.3±1降至-1.6±1，P=0.03）、zFEV1/FVC（从-0.4±1降至-1.1±1，P=0.008）和zFEF 25-75%（从-1.2±1降至-1.8±1，P=0.03）显著下降。
表面活性剂时代后出生的极早产儿表现出明显的气流受限，在支气管肺发育不良患儿中尤为明显，此外，这些患儿还呈现出异常的气道生长轨迹，在8至12岁之间肺功能下降。《儿科肺脏病学》。2016年；51：1057-1064。©2016威利期刊公司。
