摘要

Thunqvist and colleagues reported that pulmonary function testing using spirometry and oscillometry 6.5 years after pre-term birth at 22- 26 weeks EGA showed increased bronchore activity to β-agonist treatment along with impaired FVC and FEV1.The authors reported that nearly all their subjects were diagnosed with BPD, which likely affected the magnitude of impaired pulmonary function. As expected, the severity of BPD correlated with the severity of impairment. Lo and colleagues reported parallel decrements of FRC in survivors of preterm birth at 26 weeks that were measured by plethysmography and Hedilution at age 1 year and age 11-14 years. The superimposition of rapid weight gain may also contribute in this setting. Lowe and colleagues correlated high rates of fetal and infant growth among the prematurely born with postnatally reported wheezing. The effect was further worsened by maternal smoking.Jackson and colleagues analyzed data from the multi-center ELGAN study to identify risk factors for BPD and correlations with parent reported asthma in those study subjects. They found that growth restriction and gestational age affected BPD risk, but that BPD only predicted bronchodilator use at 1 and 2 years, not asthma at 10 years. As others have shown, the wheezing in patients with BPD is not allergic asthma: wheezing may be driven by abnormal airway structural development. We know that effects of BPD and prematurity on airway resistance and FRC are long-standing, but this does not appear to be the same as increasing the risk for allergic asthma. Along with other reports, the authors found that weight gain velocity during infancy also increased the risk for asthma along with maternal SES, another example of disturbed developmental programming.

译文

Thunqvist及其同事报道，在EGA 22-26周早产后6。5年使用肺活量测定法和示波法进行的肺功能测试显示，对于β-激动剂治疗，支气管活性增加，同时FVC和FEV1受损。作者报告说他们几乎所有的受试者都是诊断为BPD，可能影响肺功能受损的程度。正如预期的那样，BPD的严重程度与损伤的严重程度相关。 Lo及其同事报道，26周时早产幸存者的FRC平行下降，通过体积描记法和1岁时和11-14岁的Hedilution测量。快速增重的叠加也可能有助于此设置。 Lowe及其同事将过早出生的胎儿和婴儿生长率与出生后报告的喘息相关联。母亲吸烟会进一步恶化这种影响。Jackson及其同事分析了来自多中心ELGAN研究的数据，以确定BPD的风险因素以及与这些研究对象中父母报告的哮喘的相关性。他们发现生长受限和孕龄会影响BPD风险，但BPD仅预测1年和2年使用支气管扩张剂，而不是10年时的哮喘。正如其他人所表明的那样，BPD患者的喘息不是过敏性哮喘：喘息可能是由异常的气道结构发展引起的。我们知道BPD和早产对气道阻力和FRC的影响是长期存在的，但这似乎与增加过敏性哮喘的风险并不相同。与其他报道一起，作者发现，婴儿期体重增加速度也增加了哮喘风险以及母体SES，这是另一个受干扰的发育规划的例子。