糖皮质激素疗法防治支气管肺发育不良研究进展

Recent advances in postnatal glucocorticoid therapies for prevention and treatment of bronchopulmonary dysplasia

支气管肺发育不良（bronchopulmonary dysplasia，BPD）是早产儿常见的慢性肺损伤，糖皮质激素（glucocorticoid，GC）是最有争议的BPD防治疗法之一。目前研究证据显示，全身或局部使用GC（吸入或气管内滴注）均可降低BPD发病率；全身使用GC可导致近期或远期不良结局，特别是出生1周内全身GC疗法可导致远期神经发育不良结局；出生1～2周仍有呼吸机依赖的患儿可考虑全身使用低剂量、短疗程GC治疗；仍需进行更多设计严谨的随机对照研究验证局部GC防治BPD的效果及远期影响。

Bronchopulmonary dysplasia （BPD） is a common chronic lung injury in preterm infants.glucocorticoid（GC） is one of the most controversial therapies for prevention and treatment of BPD.Current evidence shows that systemic or partial, inhaled or intratracheal instilled GC can reduce the incidence of BPD.Systemic GC may lead to short or long-term adverse outcomes among the patients, especially early （within 1 week） postnatal GC therapy in preterm infants increased risk of adverse neurodevelopmental outcomes.Systemic low-dose and short course of GC can be considered by clinicians with caution to use for the infant who is ventilator-dependent and at risk of severe BPD at postnatal 1-2 weeks.Further randomized controlled research is needed to evaluate the effect and long-term outcomes of inhaled or intratracheal instilled GC therapies in infants at risk for BPD.