支气管肺发育不良早产儿婴儿期预后研究

Prognosis of bronchopulmonary dysplasia in preterm infants: a follow-up during infancy

目的探讨支气管肺发育不良(BPD)患儿婴儿期体格发育、呼吸系统常见疾病发生情况以及运动发育情况.方法回顾性分析2012年1月至2015年12月入住新生儿重症监护室的BPD早产儿的临床特征和婴儿期结局,并与同期住院胎龄及出生体重相近但未发生BPD的早产儿进行比较,比较两组早产儿婴儿期生长发育和运动发育情况、住院次数以及肺炎、喘息等疾病的发生情况.结果与非BPD组患儿相比,BPD组患儿出院时更容易发生宫外发育迟缓(48%vs 41%),且生后更容易发生肺炎、喘息、湿疹、鼻炎,因呼吸道感染再次住院次数增加,差异均具有统计学意义(P<0.05).矫正3月龄、6月龄及12月龄时BPD组患儿头围小于非BPD组(P<0.05).矫正6月龄及9月龄时BPD组患儿粗大运动、精细运动以及总发育商均落后于非BPD组患儿(P<0.05).结论 BPD患儿出院时容易发生宫外发育迟缓,头围增长相对缓慢,婴儿期易发生肺炎及喘息,而且矫正6月龄及9月龄运动发育落后于非BPD早产儿.

Objective To investigate the physical development, incidence of common respiratory diseases, and motor development during infancy in preterm infants with bronchopulmonary dysplasia (BPD). Methods A retrospective analysis was performed on the clinical features and infantile outcomes of preterm infants with BPD who were admitted to the neonatal intensive care unit between January 2012 and December 2015. Preterm infants without BPD were used as controls who were admitted to the neonatal intensive care unit during the same period and had similar gestational age and birth weight. Physical development, number of hospital stays, the incidences of pneumonia and wheezing, and motor development during infancy were compared between the two groups. Results Compared with the control group, BPD infants had a significantly higher incidence of extrauterine growth retardation at discharge (48% vs 41%;P<0.05);BPD infants were more susceptible to pneumonia, wheezing, eczema and rhinitis;BDP infants also had a significantly higher number of readmissions due to respiratory tract infection (P<0.05). BPD infants had a significantly smaller head circumference than the control group at corrected ages of 3, 6, and 12 months (P<0.05). BPD infants had significantly delayed gross, fine, and overall motor development than the control group at corrected ages of 6 and 9 months (P<0.05). Conclusions Infants with BPD are susceptible to extrauterine growth retardation at discharge. Their head circumference growth is relatively slow. They are susceptible to pneumonia and wheezing during infancy. Moreover, they have delayed motor development when compared with those without BPD at corrected ages of 6 and 9 months.