Macfarlane P I, Heaf D P
Respiratory Unit, Royal Liverpool Children's Hospital Alder Hey, Liverpool.
Arch Dis Child. 1988 Apr;63(4):368-72. doi: 10.1136/adc.63.4.368.
Eighteen children aged 6 to 11 years old who fulfilled criteria for the diagnosis of neonatal meconium aspiration syndrome were investigated to find out the prevalence of previous and current respiratory symptoms, and abnormal pulmonary function tests, chest radiographs, and ventilation scans. Eleven of the 18 had no respiratory symptoms and eight of these had normal pulmonary function on testing. Two had mild limitation of expiratory airflow that did not respond to treatment with bronchodilators, and one had exercise induced bronchospasm that responded to treatment with bronchodilators. Seven of the 18 had recurrent cough and wheezing compatible with a diagnosis of asthma, and five of these had appreciable exercise induced bronchospasm that responded to treatment with bronchodilators. None of the children with symptoms had a personal or family history of atopy or had had acute bronchiolitis. All chest radiographs were normal. We found a much higher prevalence of asthmatic symptoms and abnormal bronchial reactivity among survivors of neonatal meconium aspiration syndrome than in the general childhood population. Aspiration of meconium may have long term consequences for the developing respiratory tract and is associated with abnormal respiratory function in later childhood.
对18名年龄在6至11岁、符合新生儿胎粪吸入综合征诊断标准的儿童进行了调查,以了解既往和当前呼吸道症状的患病率,以及肺功能测试、胸部X光片和通气扫描异常情况。18名儿童中有11名无呼吸道症状,其中8名测试时肺功能正常。2名有轻度呼气气流受限,对支气管扩张剂治疗无反应,1名有运动诱发性支气管痉挛,对支气管扩张剂治疗有反应。18名儿童中有7名有反复发作的咳嗽和喘息,符合哮喘诊断,其中5名有明显的运动诱发性支气管痉挛,对支气管扩张剂治疗有反应。有症状的儿童均无个人或家族过敏史,也未曾患过急性细支气管炎。所有胸部X光片均正常。我们发现,新生儿胎粪吸入综合征幸存者中哮喘症状和支气管反应性异常的患病率远高于一般儿童人群。胎粪吸入可能对发育中的呼吸道产生长期影响,并与儿童后期的呼吸功能异常有关。