Berman W, Katz R, Yabek S M, Dillon T, Fripp R R, Papile L A
J Pediatr. 1986 Jul;109(1):45-50. doi: 10.1016/s0022-3476(86)80570-4.
We observed 10 children with bronchopulmonary dysplasia, evaluated initially by cardiac catheterization (mean age 18 months), for an average of 4.4 years. Age at last evaluation averaged 5.8 years; subjects reside in and around Albuquerque, N.M. (altitude 5000 ft). At initial cardiac catheterization, mean pulmonary artery pressure was 40 mm Hg, pulmonary vascular resistance index 8.9 units, and intrapulmonary shunt fraction was high; pulmonary wedge angiograms were normal. Over the period of follow-up the group has done poorly. Four of the 10 continue to receive home oxygen therapy, but none requires inotropic or diuretic therapy; four children have marked developmental or motor delays. Nine of 10 patients have abnormalities of respiratory function on spirometric testing. Four patients underwent recatheterization because of clinical indications; two had large atrial level left-to-right shunts not found on initial study. Reductions in pulmonary artery pressure (55 to 37 mm Hg) and pulmonary vascular resistance (11.9 to 7.8 units) occurred between the two studies in these four patients (average study interval 4.0 years); the still elevated levels of pressure and resistance fell further in response to 40% O2 administration. Pulmonary wedge angiograms were abnormal in each restudied patient. Although not uniformly bleak, the long-term outlook for children with severe bronchopulmonary dysplasia is diverse and guarded.
我们观察了10名患有支气管肺发育不良的儿童，最初通过心导管检查进行评估（平均年龄18个月），平均随访4.4年。最后一次评估时的平均年龄为5.8岁；研究对象居住在新墨西哥州阿尔伯克基及其周边地区（海拔5000英尺）。在心导管检查初始阶段，平均肺动脉压为40毫米汞柱，肺血管阻力指数为8.9单位，肺内分流分数较高；肺楔压血管造影正常。在随访期间，该组情况不佳。10名儿童中有4名仍在家中接受氧疗，但无人需要使用强心剂或利尿剂治疗；4名儿童有明显的发育或运动迟缓。10名患者中有9名在肺活量测试中存在呼吸功能异常。4名患者因临床指征接受了再次心导管检查；其中2名患者在初始检查中未发现的心房水平有较大的左向右分流。在这4名患者的两次检查之间（平均检查间隔4.0年），肺动脉压（从55毫米汞柱降至37毫米汞柱）和肺血管阻力（从11.9单位降至7.8单位）有所降低；在给予40%氧气后，仍升高的压力和阻力进一步下降。再次检查的每位患者肺楔压血管造影均异常。尽管并非完全黯淡，但患有严重支气管肺发育不良儿童的长期预后各不相同且不容乐观。
