Department of Pediatrics, Haukeland University Hospital, Bergen, Norway.
Department of Physiotherapy, Occupational Therapy and Radiography, Bergen University College, Bergen, Norway.
Paediatr Respir Rev. 2018 Mar;26:34-40. doi: 10.1016/j.prrv.2017.06.010. Epub 2017 Jun 20.
Being born preterm often adversely affects later lung function. Airway obstruction and bronchial hyperresponsiveness (BHR) are common findings. Respiratory symptoms in asthma and in lung disease after preterm birth might appear similar, but clinical experience and studies indicate that symptoms secondary to preterm birth reflect a separate disease entity. BHR is a defining feature of asthma, but can also be found in other lung disorders and in subjects without respiratory symptoms. We review different methods to assess BHR, and findings reported from studies that have investigated BHR after preterm birth. The area appeared understudied with relatively few and heterogeneous articles identified, and lack of a pervasive understanding. BHR seemed related to low gestational age at delivery and a neonatal history of bronchopulmonary dysplasia. No studies reported associations between BHR after preterm birth and the markers of eosinophilic inflammatory airway responses typically found in asthma. This should be borne in mind when treating preterm born individuals with BHR and airway symptoms.
早产儿出生常对后期肺功能产生不良影响。气道阻塞和支气管高反应性(BHR)是常见表现。哮喘和早产儿后肺部疾病的呼吸症状可能表现相似,但临床经验和研究表明,早产儿后出现的症状反映了一种独立的疾病实体。BHR 是哮喘的一个明确特征,但也可见于其他肺部疾病和无呼吸症状的患者。我们回顾了评估 BHR 的不同方法,并综述了研究早产儿后 BHR 的报告结果。这一领域的研究相对较少且具有异质性,尚未得到广泛的理解。BHR 似乎与分娩时的低胎龄和新生儿支气管肺发育不良病史有关。没有研究报告早产儿后 BHR 与哮喘中常见的嗜酸性炎症气道反应标志物之间存在关联。在治疗患有 BHR 和气道症状的早产儿时应牢记这一点。