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极早产儿有无支气管肺发育不良者使用脉冲振荡系统进行肺功能检测与 4 岁时临床结局的关系

Pulmonary function using impulse oscillometry system and clinical outcomes at age 4 years in children born extremely preterm with or without bronchopulmonary dysplasia.

机构信息

Centre Hospitalier Intercommunal de Créteil, Service de Pédiatrie Générale, Créteil, 94000, France; Centre des Maladies Respiratoires Rares (RESPIRARE®), CRCM, Créteil, France; University Paris Est Créteil, INSERM, IMRB, 94010, Créteil, France; FHU SENEC, Créteil, France.

Centre Hospitalier Intercommunal de Créteil, Service de Pédiatrie Générale, Créteil, 94000, France.

出版信息

Respir Med. 2024 Nov-Dec;234:107845. doi: 10.1016/j.rmed.2024.107845. Epub 2024 Oct 22.

Abstract

UNLABELLED

This study aimed to describe the early assessment of lung function and respiratory morbidity in children born extremely preterm with or without bronchopulmonary dysplasia (BPD).

METHODS

This was a prospective study including all the children born at gestational age ≤28 weeks who received treatment in the NICU of the Centre Intercommunal de Créteil in France, from January 2006 to March 2012. Lung function, using the impulse oscillometry system, respiratory morbidity and growth were assessed at age 4 years. Lung function and clinical course of children were compared in children with and without BPD.

RESULTS

We included 136 extremely premature children; 26 (19 %) had BPD. Children with and without BPD did not significantly differ in resistance measurements at 5 Hz (R) and 20 Hz (R) and reactance (X) measurements at age 4 years. A total of 104 (76 %) pre-term children had respiratory resistance R above the 95th percentile for the reference population (z-score >1.64), regardless of BPD status. The mean (SD) R z-score for all children was 2.1 (±0.7), whereas the mean (SD) R was in the normal range (z-score = 1.1 [±0.3]). After treatment with bronchodilators, all children showed no significant change in resistance. The prevalence of asthma symptoms at age 4 years was common and estimated at 30 % regardless of BPD status.

CONCLUSION

Early assessment of lung function by the impulse oscillometry system revealed that most preschool children who were born extremely preterm had abnormal total airway resistance regardless of BPD status. The system is an essential tool for the early assessment of children born prematurely.

摘要

目的

本研究旨在描述患有或不患有支气管肺发育不良(BPD)的极早产儿的肺功能和呼吸道发病率的早期评估。

方法

这是一项前瞻性研究,纳入了 2006 年 1 月至 2012 年 3 月期间在法国克里特尔社区中心新生儿重症监护病房接受治疗的所有胎龄≤28 周的儿童。在 4 岁时评估肺功能(使用脉冲振荡系统)、呼吸道发病率和生长情况。比较了患有和不患有 BPD 的儿童的肺功能和临床过程。

结果

共纳入 136 名极早产儿;其中 26 名(19%)患有 BPD。4 岁时,患有和不患有 BPD 的儿童在 5Hz(R)和 20Hz(R)的阻力测量值以及电抗(X)测量值方面没有显著差异。104 名(76%)早产儿的呼吸阻力 R 高于参考人群的第 95 百分位数(z 分数>1.64),无论 BPD 状态如何。所有儿童的平均(SD)R z 分数为 2.1(±0.7),而平均(SD)R 值在正常范围内(z 分数=1.1[±0.3])。支气管扩张剂治疗后,所有儿童的阻力均无明显变化。4 岁时哮喘症状的患病率很高,估计为 30%,无论 BPD 状态如何。

结论

通过脉冲振荡系统对肺功能的早期评估表明,大多数患有极早产儿的学龄前儿童无论 BPD 状态如何,其总气道阻力均异常。该系统是早产儿早期评估的重要工具。

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