不同程度支气管肺发育不良早产儿的临床及影像学特点

目的　探讨不同程度支气管肺发育不良(BPD)早产儿的临床及影像学特点。方法　对59例胎龄<32周BPD 早产儿的临床及影像学特点进行前瞻性研究。59例早产儿中包括轻度BPD 37例, 中/重度BPD 22例, 比较不同程度BPD患儿的临床及影像学表现。结果　中/重度BPD组患儿机械通气、氧疗、抗生素、静脉营养等应用时间及住院时间长于轻度BPD组(P<0.05), 院内感染发生率、红细胞输注次数高于轻度BPD组(P<0.05)。轻度BPD组呼吸窘迫综合征(RDS)Ⅰ级(生后1 d)、肺透亮度减低(生后4~10 d、生后28 d及以上)等X线改变比例较中/重度BPD组高(P<0.05); 中/重度BPD组BPD Ⅲ期改变(生后4~10 d)、BPD Ⅳ期改变(生后28 d及以上)等比例较轻度BPD组高(P<0.05)。结论 呼吸机、氧疗、抗生素等应用时间及院内感染发生率与BPD严重程度相关。BPD程度越重的患儿, 静脉营养时间越长, 输注红细胞次数越多, BPD影像学改变更典型。BPD影像学检查对BPD的严重程度有一定的预测作用。

Clinical and imaging features of premature infants with different degrees of bronchopulmonary dysplasia

Objective To study the clinical and imaging features of premature infants with different degrees of bronchopulmonary dysplasia (BPD). Methods A prospective study was performed on the clinical data of 59 premature infants (gestational age <32 weeks) with BPD. Among the 59 premature infants, 37 cases had mild BPD and the other 22 cases had moderate to severe BPD. The clinical and imaging data were compared between these premature infants with different degrees of BPD. Results The durations of mechanical ventilation, oxygen therapy, antibiotic therapy, parenteral nutrition, and hospitalization in the moderate to severe group were significantly longer than those in the mild group (P<0.05). The incidence of nosocomial infection and number of times of red blood cell transfusion in the moderate to severe group were significantly higher than that in the mild group. The rates of X-ray changes, including grade I respiratory distress syndrome (1 day after birth) and hypolucency of lungs (4-10 days and ≥28 days after birth) were significantly higher in the mild group than in the moderate to severe group. The rates of X-ray changes in classical BPD stage III (4-10 days after birth) and IV (≥28 days after birth) were significantly higher in the moderate to severe group than in the mild group. Conclusions The durations of mechanical ventilation, oxygen therapy, and antibiotic therapy and the incidence of nosocomial infection are correlated with the severity of BPD. The premature infants with severer BPD need a longer duration of parenteral nutrition and more times of red blood cell transfusion and have more typical imaging changes of BPD. Imaging examination has a predictive value for the severity of BPD.