支气管肺发育不良的研究进展  

Study Progress in Bronchopulmonary Dysplasia

作　　者：孔令凯[1] 章晟[2] 封志纯[1] 

机构地区：[1]北京军区总医院附属八一儿童医院早产儿NICU,北京100700 [2]北京军区总医院附属八一儿童医院临床遗传中心,北京100700

出　　处：《实用儿科临床杂志》2012年第14期1122-1126,共5页Journal of Applied Clinical Pediatrics

基　　金：国家自然科学基金(30973210)

摘　　要：支气管肺发育不良(BPD)是早产儿最常见的严重呼吸系统疾病。随着产前糖皮质激素的应用、呼吸支持的改善、肺表面活性物质(PS)的应用,经典型BPD发病率有所降低,新型BPD发生率有所增多,其发病机制主要是在基因易感性的基础上,宫内和出生后的多重打击引起促炎、抗炎因子的级联反应,对发育不成熟的肺引起损伤,以及损伤后血管化失调和肺组织异常修复。在治疗上无满意的治疗策略,目前常采用的方法包括保持适当的血氧含量,允许性高碳酸血症,早期使用无创呼吸支持,使用气管内插管-PS使用-尽早拔管改用无创呼吸支持模式,常用药物为咖啡因、类固醇、外源性PS等,但具体效果仍存在争议。Bronchopulmonary dysplasia （BPD） remains the most common severe complication of preterm birth. The introduction of pre- natal steroid use, pulmonary surfactant treatment and improved ventilator strategies have resulted in great changes from the old BPD, but the incidence of new BPD is increased than before. The new BPD is based on an impairment of lung maturation with prenatal and postnatal multi - hit insults and genetic susceptibility. The multi - hit initiates a cascade of pro - and anti - inflammatory mediators that affect the very immature lung and subsequently vascularization disorders with lung tissue repaired abnormally. There are no satisfied treatment strategy recently. New cure strategy such as adequate oxygenation, permissive hypereapnia, early use of noninvasive mechanical ventilation, INtubation SURfactant Extwbation（INSURE） approach, caffeine, corticosteroids and pulmonary surfactant are beneficial to BPD, and also need more research.

关 键 词：支气管肺发育不良 慢性肺部疾病 婴儿 早产 

分 类 号：R722.6[医药卫生—儿科]