Chest:胃食管反流为支气管肺发育不良患者晚期并发症带来潜在风险

2020-05-22 MedSci原创 MedSci原创

BPD婴儿晚期并发症的患病率很高。GER,尤其是DGER,为这些晚期并发症带来了风险。

在极低出生体重的婴儿中,支气管肺发育不良(BPD)是最常见的呼吸系统疾病。尽管大多数BPD症状均得到改善,但即使接受常规治疗也有些患者会出现晚期并发症。胃食管反流(GER)在极早产儿中也很常见,可能与许多心肺症状有关。然而,GER是否会增加BPD婴儿晚期并发症的风险尚未明确。

近日,呼吸领域权威杂志chest上发表了一篇研究文章,研究人员进行了一项多中心前瞻性队列研究,纳入了131名BPD婴儿(男婴79例,女婴52例)。经过18个月的随访评估了晚期并发症的发生情况,并分析了所有婴儿在月经后36周和最后一次就诊中的24小时pH多通道腔内阻抗(pH-MII)和胃内钠浓度。研究人员通过前向logistic回归分析BPD患儿晚期并发症的患病率和危险因素。

BPD婴儿晚期并发症的患病率为63.79%,包括呼吸道症状(49.14%)、呕吐(38.79%)、早产儿视网膜病变(ROP,25.86%)、缺氧缺血性损伤(3.45%)、再次住院(26.72%)和猝死(0.86%)。呼吸系统疾病是最常见的并发症。BPD患儿中GER的患病率为42.24%,其中包括酸性GER(18.10%)和十二指肠胃食管反流(DGER,24.14%)。呼吸系统症状的危险因素为胎龄≤30周(比值比,OR=3.213; 95%CI为1.221-8.460)、出生体重<1500g(OR=2.803; 95%CI为1.014-7.749),有创通气>7天(OR=4.952; 95%CI为1.508-16.267),酸性GER(OR=4.630; 95%CI为1.305-16.420)和DGER(OR=5.588; 95%CI为1.770-17.648)。BPD和DGER婴儿比酸性GER或无反流的婴儿更容易发生晚期并发症。

由此可见,BPD婴儿晚期并发症的患病率很高。GER,尤其是DGER,为这些晚期并发症带来了风险。

原始出处:

Luo-Jia Wang.et al.Gastroesophageal Reflux Poses a Potential Risk for Late Complications of Bronchopulmonary Dysplasia: A Prospective Cohort Study.chest.2020.https://journal.chestnet.org/article/S0012-3692(20)31447-1/fulltext

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    2020-08-29 丁鹏鹏
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target=_blank style='color:#2F92EE;'>#胃食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83397, encryptionId=87828339e7a, topicName=胃食管)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=循证小兵, createdTime=Thu Jul 30 02:00:51 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1808723, encodeId=dea91808e23ce, content=<a href='/topic/show?id=098d820866b' target=_blank style='color:#2F92EE;'>#肺发育不良#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82086, encryptionId=098d820866b, topicName=肺发育不良)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9fe6351, createdName=flyingeagle77, createdTime=Tue Apr 13 08:00:51 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929636, encodeId=9290192963675, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Sat Aug 29 20:00:51 CST 2020, time=2020-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1260714, encodeId=c2551260e14eb, content=<a href='/topic/show?id=2f71834056f' target=_blank style='color:#2F92EE;'>#胃食管反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83405, encryptionId=2f71834056f, topicName=胃食管反流)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sun May 24 14:00:51 CST 2020, time=2020-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1347475, encodeId=f215134e475ab, content=<a href='/topic/show?id=88713e938c1' target=_blank style='color:#2F92EE;'>#发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37938, encryptionId=88713e938c1, topicName=发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f4c124, createdName=neurowu, createdTime=Sun May 24 14:00:51 CST 2020, time=2020-05-24, status=1, ipAttribution=)]
  8. 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topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Sat Aug 29 21:00:51 CST 2020, time=2020-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1997752, encodeId=b480199e7528f, content=<a href='/topic/show?id=5feb5982e8d' target=_blank style='color:#2F92EE;'>#晚期并发症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59827, encryptionId=5feb5982e8d, topicName=晚期并发症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db5b227, createdName=gostraight, createdTime=Sat Jul 18 09:00:51 CST 2020, time=2020-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892234, encodeId=d275189223484, content=<a href='/topic/show?id=1b445e1232d' target=_blank style='color:#2F92EE;'>#支气管#</a>, beContent=null, objectType=article, channel=null, level=null, 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createdTime=Tue Apr 13 08:00:51 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929636, encodeId=9290192963675, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Sat Aug 29 20:00:51 CST 2020, time=2020-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1260714, encodeId=c2551260e14eb, content=<a href='/topic/show?id=2f71834056f' target=_blank style='color:#2F92EE;'>#胃食管反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83405, encryptionId=2f71834056f, topicName=胃食管反流)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sun May 24 14:00:51 CST 2020, time=2020-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1347475, encodeId=f215134e475ab, content=<a href='/topic/show?id=88713e938c1' target=_blank style='color:#2F92EE;'>#发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37938, encryptionId=88713e938c1, topicName=发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f4c124, createdName=neurowu, createdTime=Sun May 24 14:00:51 CST 2020, time=2020-05-24, status=1, ipAttribution=)]
    2020-08-29 Smile2680
  9. 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  10. 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    2020-05-24 neurowu

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