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支气管肺发育不良的短期和长期并发症

Short- and Long-Term Complications of Bronchopulmonary Dysplasia.

作者信息

Homan Travis D, Nayak Ravi P

机构信息

Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, Missouri.

出版信息

Respir Care. 2021 Oct;66(10):1618-1629. doi: 10.4187/respcare.08401.

Abstract

Bronchopulmonary dysplasia (BPD) is a chronic lung disease most commonly seen in preterm infants of low birthweight who required postnatal respiratory support. Although overall incidence rates have not changed, recent advancements in medical care have resulted in lower mortality rates, and those affected are beginning to live longer. As a result, the long-term repercussions of BPD are becoming more apparent. Whereas BPD has been thought of as a disease of just the lungs, resulting in abnormalities such as increased susceptibility to pulmonary infections, impaired exercise tolerance, and pulmonary hypertension, the enduring complications of BPD have been found to extend much further. This includes an increased risk for cerebral palsy and developmental delays, lower intelligence quotient (IQ) scores, impaired executive functioning, behavioral challenges, delays in expressive and receptive language development, and an increased risk of growth failure. In addition, the deficits of BPD have been found to influence much more than just physical health; BPD survivors have been noted to have higher rates of health care use, starting with the initial hospitalization and continuing with therapy and specialist follow-up, as well as impairments in quality of life, both physical and psychological, that continue into adulthood. The long-term consequences of BPD may best be addressed through future research, including better understanding of the pathophysiologic mechanisms leading to BPD, further comparisons between newborns with BPD and those without, and long-term assessment and management of BPD patients as adults.

摘要

支气管肺发育不良(BPD)是一种慢性肺部疾病,最常见于出生体重低且出生后需要呼吸支持的早产儿。尽管总体发病率没有变化,但医疗护理的最新进展已降低了死亡率,且患病婴儿的寿命开始延长。因此,BPD的长期影响正变得更加明显。虽然BPD一直被认为只是一种肺部疾病,会导致诸如肺部感染易感性增加、运动耐量受损和肺动脉高压等异常情况,但现已发现BPD的持续性并发症影响范围更广。这包括患脑瘫和发育迟缓的风险增加、智商(IQ)得分降低、执行功能受损、行为问题、表达性和接受性语言发育延迟以及生长发育迟缓风险增加。此外,已发现BPD的缺陷不仅影响身体健康;据观察,BPD幸存者从最初住院开始,到后续的治疗和专科随访,医疗保健使用率较高,而且其身体和心理生活质量受损情况会持续到成年期。BPD的长期后果或许最好通过未来的研究来解决,包括更好地理解导致BPD的病理生理机制、对患有BPD和未患BPD的新生儿进行进一步比较,以及对成年BPD患者进行长期评估和管理。

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