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Lung function development after preterm birth in relation to severity of Bronchopulmonary dysplasia

机译:早产后肺功能的发展与支气管肺发育不良的严重程度有关

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Background Bronchopulmonary dysplasia (BPD) is a strong risk factor for respiratory morbidity in children born preterm. Our aims were to evaluate lung function in adolescents born preterm with and without a history of BPD, and to assess lung function change over time from school age. Methods Fifty-one individuals born in Stockholm, Sweden between gestational ages 24 to 31?weeks (23 neonatally diagnosed with respiratory distress syndrome (RDS) but not BPD, and 28 graded as mild ( n =?17), moderate ( n =?7) or severe ( n =?4) BPD) were examined in adolescence (13–17?years of age) using spirometry, impulse oscillometry (IOS), plethysmography, and ergospirometry. Comparison with lung function data from school age (6–8?years of age) was also performed. Results Adolescents with a history of BPD had lower forced expiratory volume in 1?s (FEV1) compared to those without BPD (?0.61 vs.-0.02 z-scores, P 1 values significantly associated with BPD severity ( P for trend 0.002). Subjects with severe BPD had higher frequency dependence of resistance, R5–20, ( P 1/FVC z-scores decreased in all groups and particularly in the severe BPD group (from ?1.68 z-scores at 6–8?years to ?2.74 z-scores at 13–17?years, p Conclusions Our results of spirometry and IOS measures in the BPD groups compared to the non-BPD group suggest airway obstruction including involvement of peripheral airways. The longitudinal result of a decrease in FEV1/FVC in the group with severe BPD might implicate a route towards chronic airway obstruction in adulthood.
机译:背景支气管肺发育不良(BPD)是早产儿呼吸系统疾病的重要危险因素。我们的目的是评估有无BPD病史的早产青少年的肺功能,并评估从学龄开始随时间变化的肺功能变化。方法在瑞典斯德哥尔摩的21个胎龄为24到31周的婴儿中出生(23例新生儿被诊断为呼吸窘迫综合征(RDS),但没有BPD,28例为轻度(n =?17),中度(n =? 7岁或严重(n = 4)BPD)在青春期(13-17岁)使用肺活量测定,脉冲示波法(IOS),体积描记法和人体工程肺量测定法进行了检查。还与学龄儿童(6-8岁)的肺功能数据进行了比较。结果具有BPD病史的青少年在1?s(FEV 1 )中的强迫呼气量低于没有BPD的青少年(?0.61 vs.-0.02 z-score,P 1 值与BPD严重程度显着相关(趋势P为0.002)。严重BPD受试者的耐药性频率依赖性更高,R 5-20 ,(所有患者的P 1 / FVC z评分均下降组,特别是在严重的BPD组中(从6-8岁的1.68 z分数到13-17岁的2.74 z分数,p结论与BPD组相比,我们的BPD组肺活量测定和IOS测量结果非BPD组提示气道阻塞包括周围气道受累,严重BPD组FEV 1 / FVC降低的纵向结果可能暗示了成年后慢性气道阻塞的途径。

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