Clément A
Service de Physiologie, Hôpital Trousseau, Paris.
Rev Mal Respir. 1996 Jul;13(3):243-9.
Bronchopulmonary dysplasia (BPD), a respiratory disorder first described in prematurely born infants with respiratory distress syndrome (RDS) treated with mechanical ventilation and oxygen supplementation, is the most common cause of chronic lung disease in infants. It is defined as the need for increased inspired oxygen at 28 days of age, and is observed with the highest frequency following premature delivery of very low birth weight infants. Indeed, an incidence of 48% has been recently reported in a population with a mean gestational age of 27 weeks. The etiology of BPD is multifactorial including lung immaturity, respiratory distress, oxygen therapy, and mechanical ventilation. Based on the current understanding of the pathogenesis of the disease, several therapeutical strategies are used. One of them is focused on the prevention of BPD by correcting surfactant deficiency in premature infants with RDS using exogenous surfactant, and also by improving the techniques of mechanical ventilation used for the management of RDS. Another approach which is being developed is focused on the factors involved in the processes of repair of the injured immature lung. These factors include the use of inhibitors of the inflammatory cascade, antioxidants, and inhibitors of fibrosis.
支气管肺发育不良(BPD)是一种呼吸系统疾病,最初在接受机械通气和补充氧气治疗的患有呼吸窘迫综合征(RDS)的早产儿中被描述,是婴儿慢性肺病的最常见原因。它被定义为在28日龄时需要增加吸入氧,并且在极低出生体重儿早产之后观察到的频率最高。事实上,最近在平均胎龄为27周的人群中报告的发病率为48%。BPD的病因是多因素的,包括肺不成熟、呼吸窘迫、氧疗和机械通气。基于目前对该疾病发病机制的理解,使用了几种治疗策略。其中之一是通过使用外源性表面活性剂纠正患有RDS的早产儿的表面活性剂缺乏,以及通过改进用于管理RDS的机械通气技术来预防BPD。正在开发的另一种方法集中于参与受损未成熟肺修复过程的因素。这些因素包括使用炎症级联反应抑制剂、抗氧化剂和纤维化抑制剂。