摘要
验证支气管肺发育不良(BPD)患儿中存在较高的非对称含水量及其与不均匀的肺损伤有关的假说。笔者使用磁共振对20名婴儿的肺含水量和35名胎龄为23-33周的患儿的肺组织损伤(其中15例重度BPD, 13例轻度BPD,7例无BPD)进行评估。根据图像的相对质子密度来判断积水的量和分布情况。同时,对提示肺损伤的病灶密度影和囊样结构的定位和程度也加以确定。在肺损伤的相关部位有明显的较高质子密度影。结果发现,在严重BPD的患儿中,图像平均质子密度、图像质子密度梯度和肺损伤的严重度都较高。其中,以肺后叶损伤最重。因此,可以得出,BPD与较高的肺水负荷和重力依赖的肺不张以及(或)肺泡积水有关。婴儿肺后叶容易发生严重的肺损伤。患有BPD的患儿会出现肺含水量增加,且更容易发生重力引起的肺不张和(或) 相关肺的肺泡积水。这些局灶性组织损伤呈不均匀分布。
To test the hypothesis that high and asymmetrical water content persists in infants with bronchopulmonary dysplasia (BPD) and that this is associated with nonuniform lung damage. Magnetic resonance imaging was used to assess lung water content in 20 infants and tissue injury in 35 infants of 23 to 33 weeks' gestational age (15 with severe BPD, 13 with mild BPD, and 7 without BPD) . Relative proton density provided an index of water content and distribution. The location and extent of focal densities and cyst-like appearances indicating lung damage were defined. Proton density was significantly higher in dependent regions. Average proton density, proton density gradient, and severity of lung damage were greater in infants with severe BPD. Indicators of damage were greatest in dorsal lung regions. BPD was associated with a higher lung water burden and gravity-dependent atelectasis and/or alveolar flooding. Lesions were more common in dorsal lung regions in infants with severe lung damage. Infants with BPD have increased lung water and are susceptible to gravity-induced collapse and/or alveolar flooding in the dependent lung. Focal tissue damage appears to be distributed in homoge-nously.
