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极低出生体重的支气管肺发育不良幸存者在6至14岁时的心脏结局与对照组相似。

Very low birthweight bronchopulmonary dysplasia survivors had similar cardiac outcomes to controls at six years to 14 years of age.

作者信息

Suursalmi Piia, Eerola Anneli, Poutanen Tuija, Korhonen Päivi, Kopeli Tarja, Tammela Outi

机构信息

Department of Pediatrics, Tampere University Hospital, Tampere, Finland.

Tampere Center for Child Health Research, Tampere University Hospital and University of Tampere, Tampere, Finland.

出版信息

Acta Paediatr. 2017 Feb;106(2):261-267. doi: 10.1111/apa.13647. Epub 2016 Nov 17.

Abstract

AIM

This study evaluated cardiac function and its associations with lung function and neonatal pulmonary morbidity in very low birthweight (VLBW) children, with and without severe radiographic bronchopulmonary dysplasia (radBPD), at school age.

METHODS

We examined 18 VLBW children with radBPD, 17 VLBW children without radBPD and 18 healthy term-born children using conventional echocardiography, tissue Doppler imaging, speckle tracking echocardiography and real-time three-dimensional echocardiography at six years to 14 years of age. Lung function was studied by impulse oscillometry. Plasma N-terminal-proBNP concentrations were measured.

RESULTS

Cardiac function and N-terminal-proBNP concentrations did not differ between the groups. No associations were found between cardiac function and neonatal dexamethasone, oxygen or ventilator therapies. In VLBW children, poorer reactance correlated with larger left ventricle (LV) end-systolic (Spearman's ρ = -0.45) and end-diastolic (ρ = -0.50) volumes and higher resistance correlated with higher LV dyssynchrony indexes, with ρ ranging from 0.37 to 0.48. Greater bronchodilation responses correlated with lower early diastolic myocardial relaxation velocities, with ρ ranging from 0.39 to 0.42.

CONCLUSION

BPD survivors had normal cardiac function at the age of six years to 14 years. No associations were found between neonatal pulmonary morbidity and cardiac parameters. Poorer lung function correlated modestly with LV echocardiographic parameters in VLBW children.

摘要

目的

本研究评估了极低出生体重(VLBW)儿童在学龄期有无严重放射性支气管肺发育不良(radBPD)时的心脏功能及其与肺功能和新生儿肺部疾病的关联。

方法

我们使用传统超声心动图、组织多普勒成像、斑点追踪超声心动图和实时三维超声心动图,对18例患有radBPD的VLBW儿童、17例无radBPD的VLBW儿童和18例足月健康出生儿童在6至14岁时进行了检查。通过脉冲振荡法研究肺功能。测量血浆N末端脑钠肽前体(N-terminal-proBNP)浓度。

结果

各组之间的心脏功能和N末端脑钠肽前体浓度无差异。未发现心脏功能与新生儿地塞米松、氧气或通气治疗之间存在关联。在VLBW儿童中,较差的电抗与较大的左心室(LV)收缩末期(Spearman氏ρ=-0.45)和舒张末期(ρ=-0.50)容积相关,较高的阻力与较高的LV不同步指数相关,ρ范围为0.37至0.48。更大的支气管扩张反应与较低的舒张早期心肌松弛速度相关,ρ范围为0.39至0.42。

结论

BPD幸存者在6至14岁时心脏功能正常。未发现新生儿肺部疾病与心脏参数之间存在关联。在VLBW儿童中,较差的肺功能与LV超声心动图参数存在适度关联。

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