Division of Neonatal-Perinatal Medicine, Department of Pediatrics.
Division of Pulmonary Medicine, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Curr Opin Pediatr. 2020 Apr;32(2):252-260. doi: 10.1097/MOP.0000000000000884.
To summarize the current literature evaluating long-term pulmonary morbidity among surviving very preterm infants with bronchopulmonary dysplasia (BPD).
BPD predisposes very preterm infants to adverse respiratory signs and symptoms, greater respiratory medication use, and more frequent need for rehospitalization throughout early childhood. Reassuringly, studies also indicate that older children and adolescents with BPD experience, on average, similar functional status and quality of life when compared to former very preterm infants without BPD. However, measured deficits in pulmonary function may persist in those with BPD and indicate an increased susceptibility to early-onset chronic obstructive pulmonary disease during adulthood. Moreover, subtle differences in exercise tolerance and activity may put survivors with BPD at further risk of future morbidity in later life.
Despite advances in neonatal respiratory care, a diagnosis of BPD continues to be associated with significant pulmonary morbidity over the first two decades of life. Long-term longitudinal studies are needed to determine if recent survivors of BPD will also be at increased risk of debilitating pulmonary disease in adulthood.
总结目前关于患有支气管肺发育不良(BPD)的存活极早产儿长期肺部发病率的文献。
BPD 使极早产儿易发生呼吸不良症状和体征,需要更多的呼吸药物治疗,并且在整个儿童早期更频繁地需要再次住院治疗。令人欣慰的是,研究还表明,患有 BPD 的大龄儿童和青少年的功能状态和生活质量平均与没有 BPD 的前极早产儿相似。然而,在那些患有 BPD 的人中,肺功能的测量缺陷可能仍然存在,并表明在成年期更容易发生早发性慢性阻塞性肺疾病。此外,在运动耐量和活动方面的细微差异可能使患有 BPD 的幸存者在以后的生活中面临更高的未来发病风险。
尽管新生儿呼吸护理取得了进展,但 BPD 的诊断仍与生命最初 20 年中显著的肺部发病率相关。需要进行长期纵向研究,以确定最近的 BPD 幸存者是否也会增加成年期患致残性肺部疾病的风险。