Farstad T, Brockmeier F, Bratlid D
Department of Paediatrics, University Hospital, Rikshospitalet, Oslo, Norway.
Eur J Pediatr. 1995 Oct;154(10):853-8. doi: 10.1007/BF01959797.
Twenty-three premature infants (GA 28.8 +/- 0.5 weeks) with bronchopulmonary dysplasia (BPD) and 14 premature infants (controls, GA 33.0 +/- 1.2 weeks) with moderate respiratory distress syndrome or with mild respiratory disturbances, were evaluated for impairment of cardiopulmonary function at 50 and 120 weeks corrected age. Respiratory system compliance was reduced in both groups, but improved with advancing age. Respiratory system resistance was initially increased, especially in the BPD group, but improved gradually. Maximum flow at functional residual capacity (VmaxFRC ml/s) indicated, nevertheless, severe peripheral obstruction (flow < 84 ml/s) in 16/20 of infants with BPD and in 7/12 of control infants at 50 weeks corrected age. At 120 weeks corrected age none of the control patients had severe peripheral pulmonary obstruction (flow < 120 ml/s), while this was still found in 5/13 infants with BPD. Doppler echocardiography indicated cardiac involvement (shortened pulmonary acceleration time) in patients with the most severe peripheral pulmonary obstruction. Pulmonary morbidity was also higher in the BPD group, and these infants were shorter and weighed less than the control infants. CONCLUSION. Measurements of maximum flow at functional residual capacity as well as cardiac evaluation are essential elements in follow up of infants with severe BPD.
对23例患有支气管肺发育不良（BPD）的早产儿（孕龄28.8±0.5周）和14例患有中度呼吸窘迫综合征或轻度呼吸障碍的早产儿（对照组，孕龄33.0±1.2周）在矫正年龄50周和120周时进行心肺功能损害评估。两组的呼吸系统顺应性均降低，但随年龄增长而改善。呼吸系统阻力最初增加，尤其是在BPD组，但逐渐改善。然而，在矫正年龄50周时，16/20的BPD婴儿和7/12的对照婴儿的功能残气量时的最大流速（VmaxFRC ml/s）表明存在严重的外周阻塞（流速<84 ml/s）。在矫正年龄120周时，对照患者均无严重的外周肺阻塞（流速<120 ml/s），而在5/13的BPD婴儿中仍发现有这种情况。多普勒超声心动图显示，外周肺阻塞最严重的患者存在心脏受累（肺动脉加速时间缩短）。BPD组的肺部发病率也更高，这些婴儿比对照婴儿更矮、体重更轻。结论。功能残气量时的最大流速测量以及心脏评估是重度BPD婴儿随访中的重要内容。
