Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom.
Asthma UK Centre for Allergic Mechanisms in Asthma, King's College London, London, United Kingdom.
PLoS One. 2020 Aug 7;15(8):e0237080. doi: 10.1371/journal.pone.0237080. eCollection 2020.
We previously demonstrated corticosteroid administration on the neonatal intensive care unit was associated with reduced lung function at 11 to 14 years of age in children born very prematurely. The objective of this observational study was to assess if lung function remained impaired at 16 to 19 years of age in those who had received postnatal corticosteroids and whether the trajectory of lung function with increasing age differed between those who had and had not received corticosteroids. One hundred and fifty-nine children born prior to 29 weeks of gestational age had comprehensive lung function measurements; 49 had received postnatal dexamethasone. Lung function outcomes were compared between those who had and had not received postnatal dexamethasone after adjustment for neonatal factors. Forced expiratory flow at 75%, 50%, 25% and 25-75% of the expired vital capacity, forced expiratory volume in one second, peak expiratory flow and forced vital capacity and lung volumes (total lung capacity and residual volume) were assessed. The majority of results were significantly lower in those who received dexamethasone (between 0.61 to 0.78 standard deviations). Lung function reduced as the number of courses of dexamethasone increased. Between 11 and 14 years and 16 to 19 years, lung function improved in the unexposed group, but forced expiratory flow at 75% of the expired vital capacity and forced expiratory volume in one second deteriorated in those who had received postnatal corticosteroids (p = 0.0006). These results suggest that prematurely born young people who received postnatal corticosteroids may be at risk of premature onset of chronic obstructive pulmonary disease.
我们之前的研究表明，在新生儿重症监护病房中使用皮质类固醇与出生极早早产儿在 11 至 14 岁时的肺功能下降有关。本观察性研究的目的是评估在接受了产后皮质类固醇治疗的人群中，肺功能是否在 16 至 19 岁时仍存在受损，以及在接受和未接受皮质类固醇治疗的人群中，肺功能随年龄增长的轨迹是否存在差异。159 名胎龄在 29 周以下的儿童接受了全面的肺功能测量；其中 49 名接受了产后地塞米松治疗。在调整了新生儿因素后，比较了接受和未接受产后地塞米松治疗的儿童的肺功能结果。比较了接受和未接受产后地塞米松治疗的儿童之间的用力呼气流量在 75%、50%、25%和 25-75%肺活量、一秒用力呼气量、呼气峰流量和用力肺活量以及肺容积（总肺活量和残气量）的结果。大多数结果在接受地塞米松治疗的儿童中明显较低（0.61 至 0.78 个标准差）。随着地塞米松疗程的增加，肺功能逐渐下降。在 11 至 14 岁和 16 至 19 岁之间，未暴露组的肺功能有所改善，但接受过产后皮质类固醇治疗的儿童的 75%肺活量用力呼气流量和一秒用力呼气量恶化（p = 0.0006）。这些结果表明，接受过产后皮质类固醇治疗的早产儿可能有患慢性阻塞性肺疾病的风险。
