Cochran D P, Pilling D W, Shaw N J
Regional Neonatal Intensive Care Unit, Liverpool Maternity Hospital, UK.
Br J Radiol. 1994 Dec;67(804):1155-7. doi: 10.1259/0007-1285-67-804-1155.
Chronic lung disease of prematurity (CLD) can be classified using the chest radiograph taken on day 28 into type 1 (homogeneous opacification) or type 2 (the presence of cystic change) and it has been suggested that the presence of pulmonary interstitial emphysema (PIE) leads to the development of type 2 CLD. To further study this relationship we examined the chest radiographs taken on days 1-7, 14, 21 and 28, of 202 infants treated at Liverpool Maternity Hospital between January 1980 and December 1989 who developed CLD. 39% (54/137) of infants who developed type 1 CLD had suffered from PIE compared with 78% (51/65) with type 2 CLD (p < 0.001). There was no difference in the incidence of PIE in infants who developed CLD and subsequently died compared with those who survived. In the infants who survived there was no significant difference in length of oxygen dependency between those who suffered from PIE (median 99 days oxygen dependent) and those who had no PIE (median 105 days). We conclude that the presence of PIE is associated with subsequent development of type 2 CLD but is not a prerequisite for this radiographic type of chronic lung disease. Of those infants who survive to develop CLD, the presence of PIE does not alter prognosis in terms of duration of oxygen dependency or mortality.
早产儿慢性肺病（CLD）可根据出生后第28天拍摄的胸部X光片分为1型（均匀性肺不张）或2型（存在囊性改变），有人认为肺间质气肿（PIE）的存在会导致2型CLD的发生。为了进一步研究这种关系，我们检查了1980年1月至1989年12月在利物浦妇产医院接受治疗并患上CLD的202名婴儿在出生后第1 - 7天、14天、21天和28天拍摄的胸部X光片。患上1型CLD的婴儿中有39%（54/137）曾患PIE，而患上2型CLD的婴儿中这一比例为78%（51/65）（p<0.001）。患上CLD并随后死亡的婴儿与存活婴儿的PIE发病率没有差异。在存活的婴儿中，患PIE的婴儿（中位氧依赖时间99天）和未患PIE的婴儿（中位氧依赖时间105天）在氧依赖时间长度上没有显著差异。我们得出结论，PIE的存在与随后2型CLD的发生相关，但不是这种影像学类型的慢性肺病的先决条件。在存活至患上CLD的婴儿中，PIE的存在在氧依赖持续时间或死亡率方面不会改变预后。
