Department of Paediatrics and Adolescent Medicine, Centre for Follow-Up Care of Ex-Preterm Babies, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
Division of Neonatology, Department of Obstetrics and Gynaecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
Pediatr Pulmonol. 2020 May;55(5):1124-1130. doi: 10.1002/ppul.24704. Epub 2020 Mar 2.
There is no strict correlation between early bronchopulmonary dysplasia and long-term respiratory disease. Early inhaled corticosteroids seem to reduce the incidence of bronchopulmonary dysplasia, but the long-term outcome remains unknown.
The aim of this study was to evaluate the effect of early inhaled corticosteroids on chronic respiratory morbidity.
Fifty-nine survivors from the Prague cohort included in Neonatal European Study of Inhaled Steroids underwent further follow-up comprising of respiratory morbidity monitoring during the first 2 years of life followed by objective lung function testing performed at the age of 5.9 years (range 5-7 years). Both outcomes were pursued and finalized before the unblinding of budesonide subgroups.
Fifty randomized (budesonide vs placebo group, 56% vs 44%) survivors were included in the study. Spirometry was successfully performed in 48 children. No statistically significant differences were found in the lung function test (forced expiratory flow [FEF] - FEF , FEF FEF , and FEF FEV , forced vital capacity [FVC], FEV /FVC) although mild trend to the improvement of expiratory flow pattern was observed in the budesonide group (median z-score of FEV /FVC -0.376 vs -0.983, P = .13; median z-score of FEF -1.004 vs -1.458, P = .13; median z-score of FEF -0.527 vs -0.996, P = .17). Children assigned to budesonide had a significantly lower rate of symptoms of chronic lung disease (34.6% vs 68.2%; P = .04) than children assigned to placebo.
Our study suggests that early inhaled budesonide was associated with the trend to the improvement of functional lung parameters and with a lower rate of symptoms of chronic lung disease within the first 2 years of life.
早期支气管肺发育不良与长期呼吸系统疾病之间没有严格的相关性。早期吸入皮质类固醇似乎可以降低支气管肺发育不良的发生率，但长期结果仍不清楚。
本研究旨在评估早期吸入皮质类固醇对慢性呼吸发病率的影响。
布拉格队列中的 59 名幸存者参加了新生儿欧洲吸入类固醇研究，进一步随访包括生命的前 2 年内的呼吸发病率监测，随后在 5.9 岁（范围为 5-7 岁）时进行客观肺功能测试。这两个结果都在布地奈德亚组的盲法解除之前进行了追踪和完成。
50 名随机分配（布地奈德与安慰剂组，56%与 44%）的幸存者纳入研究。48 名儿童成功进行了肺功能检查。虽然在布地奈德组观察到呼气流量模式有轻微改善的趋势，但肺功能测试（用力呼气流量[FEF] - FEF ，FEF FEF ，和 FEF FEV ，用力肺活量[FVC]，FEV / FVC）中未发现统计学上的显著差异（布地奈德组的 FEV / FVC 中位数 z 评分-0.376 与-0.983，P=0.13；FEF 中位数 z 评分-1.004 与-1.458，P=0.13；FEF 中位数 z 评分-0.527 与-0.996，P=0.17）。与安慰剂组相比，接受布地奈德治疗的儿童慢性肺病症状的发生率显著较低（34.6%比 68.2%；P=0.04）。
我们的研究表明，早期吸入布地奈德与功能肺参数的改善趋势以及生命的前 2 年内慢性肺病症状的发生率降低有关。
