Giacoia G P, Venkataraman P S, West-Wilson K I, Faulkner M J
Department of Pediatrics, University of Oklahoma College of Medicine Health Sciences Center, Tulsa 74129, USA.
J Pediatr. 1997 Mar;130(3):400-8. doi: 10.1016/s0022-3476(97)70231-2.
To investigate the outcome of school-age children with bronchopulmonary dysplasia (BPD) in terms of nutrition, pulmonary function, and intelligence, and to compare the results with a preterm cohort matched for gestational age and birth weight, and with a term control group.
Cross-sectional.
Follow-up clinic at level III neonatal intensive care unit, university-affiliated hospital, Children's Hospital.
Twelve children who had BPD as infants and 2 control groups of 12 children each.
Anthropometric measurements, dietary intake, resting energy expenditure, pulmonary function, body composition measurements by dual energy x-ray absorptiometry, and Weschler intelligence test scores.
Children with BPD had decreased forced expiratory volume at 1 second, decreased forced expiratory flow between 25% and 75% of vital capacity, and decreased maximal expiratory flow velocity at 50% of vital capacity compared with age-matched normal inborn subjects (p = 0.025, p = 0.005, and p = 0.0013, respectively). Both children with BPD and matched preterm control children were shorter than infants in the term control group (p = 0.018). There were no significant differences in the other anthropometric parameters studied. The groups did not differ in resting energy expenditure. Lean body mass was lower in the BPD group compared with the term control groups (p = 0.017). Bone mineral content was lower in the BPD group compared with both the preterm and term control infants (p = 0.050 and p = 0.059, respectively). The mean performance intelligence quotient (IQ) and full-scale IQ scores in the BPD group were lower than in the term control group (p = 0.011 and p = 0.029, respectively). The proportion of children with borderline or intellectually deficient scores was significantly higher in the preterm group compared with the term group for verbal, performance, and full-scale IQ scales (p = 0.046, p = 0.018, and p = 0.048 respectively). The proportion of children with BPD who had borderline or deficient performance IQ scores was higher than for the term group (p = 0.046).
The lower height and intelligence scores in children with BPD may be related to prematurity and perinatal events rather than pulmonary disease. Subclinical pulmonary dysfunction in children with BPD persists at school age. The lower amount of lean body mass and possible decrease in bone mineral content in children with BPD may be related to their smaller size.
研究学龄期支气管肺发育不良（BPD）患儿在营养、肺功能和智力方面的结局，并将结果与胎龄和出生体重匹配的早产队列以及足月儿对照组进行比较。
横断面研究。
大学附属医院儿童医院三级新生儿重症监护病房的随访门诊。
12名婴儿期患BPD的儿童以及2个对照组，每组12名儿童。
人体测量指标、饮食摄入量、静息能量消耗、肺功能、双能X线吸收法测量的身体成分以及韦氏智力测试分数。
与年龄匹配的正常足月儿相比，BPD患儿1秒用力呼气量降低、肺活量25%至75%之间的用力呼气流量降低、肺活量50%时的最大呼气流速降低（分别为p = 0.025、p = 0.005和p = 0.0013）。BPD患儿和匹配的早产对照组儿童均比足月儿对照组婴儿矮（p = 0.018）。所研究的其他人体测量参数无显著差异。各组静息能量消耗无差异。BPD组的瘦体重低于足月儿对照组（p = 0.017）。BPD组的骨矿物质含量低于早产和足月儿对照组婴儿（分别为p = 0.050和p = 0.059）。BPD组的平均操作智商（IQ）和全量表IQ分数低于足月儿对照组（分别为p = 0.011和p = 0.029）。在言语、操作和全量表IQ量表方面，早产组边缘智力或智力缺陷分数儿童的比例显著高于足月儿组（分别为p = 0.046、p = 0.018和p = 0.048）。BPD患儿中操作IQ分数处于边缘或缺陷水平的比例高于足月儿组（p = 0.046）。
BPD患儿身高和智力分数较低可能与早产和围产期事件有关，而非肺部疾病。BPD患儿的亚临床肺功能障碍在学龄期持续存在。BPD患儿瘦体重较低以及骨矿物质含量可能降低可能与其身材较小有关。
