支气管肺发育不良的药物治疗证据及临床应用

Evidence and Clinical Application of Drug Treatment on Bronchopulmonary Dysplasia

目的支气管肺发育不良(bronchopulmonary dysplasia,BPD)是目前早产儿较难治疗的并发症之一。近20年来,支气管肺发育不良发病率随着早产儿存活率的增加而增加,临床特征也随之发生变化。对支气管肺发育不良的定义,从40多年前首次提出的老支气管肺发育不良发展成为新支气管肺发育不良。目前,不管是治疗呼吸窘迫综合征(respiratory distress syndrome,RDS)以期预防支气管肺发育不良发生的药物,还是治疗支气管肺发育不良的药物本身,均有极大进展。虽然已有一些很好的证据,支持对支气管肺发育不良治疗药物的"常规"运用,但目前很多治疗方式,仍依据经验而采用。本文就目前支气管肺发育不良防治相关药物的治疗证据,综述如下,以期为临床提供参考。

Bronchopulmonary dysplasia （BPD） is one of the most challenging complications in premature infants.The incidence of bronchopulmonary dysplasia has been increasing over the past two decades in parallel with an improvement in the survival of this population.Furthermore,clinical characteristics of preterm infants affected by bronchopulmonary dysplasia have changed considerably,and the newer definition to clarify the term of bronchopulmonary dysplasia have also evolved since its first description more than four decades ago.Several drug therapies have also evolved,either to manage these infants′ respiratory distress syndrome（RDS） with an aim to prevent bronchopulmonary dysplasia or to manage the established condition.Although there is good evidence to support the ′routine′ use of some therapies,many other therapies currently used in relation to bronchopulmonary dysplasia remain on experiences that we have adopted.In this article,we discuss the support for the drug therapies used in relation to bronchopulmonary dysplasia,so as to provide bases for the clinical use of these drugs.