早产儿支气管肺发育不良的表型演变

Phenotypic evolution of bronchopulmonary dysplasia in premature infants

支气管肺发育不良(bronchopulmonary dysplasia,BPD)是早产儿最常见的慢性肺部疾病,与婴儿死亡率、呼吸系统发病率增加有关。随着新生儿重症医学取得进展的同时,BPD的表型已从主要影响晚期早产儿、肺纤维囊性变演变为主要影响胎龄小于28周的超早产儿、肺实质受损和血管生长失调。文章评估了BPD定义演变、病理生理演变、影像演变及临床表型的演变特点,以期寻找新的循证预防和管理策略,改善疾病表型分类,早期识别高危早产儿的临床特点,以改善其预后。

Bronchopulmonary dysplasia(BPD)is the commonest chronic lung disease in preterm infants,and is associated with increased infant mortality and respiratory incidence rate.With the progress of neonatal intensive care medicine,the phenotype of BPD has evolved from fibrocystic disease affecting late preterm infants to lung parenchyma damage and vascular growth disorder mainly affecting infants born 28 weeks ago.In this article,we evaluated the evolution of the definition,pathophysiology,imaging and clinical phenotypes of BPD in order to find new evidence-based prevention and management strategies,to improve the classification of disease phenotypes,to early identify the clinical characteristics of high-risk premature infants and improve their prognosis.