关键词: 支气管肺发育不良, 布地奈德, 雾化吸入, 长期影响

Abstract: Objective To study the effect of different budesonide inhalation strategies on the quality of life of preterm infants with moderate bronchopulmonary dysplasia(BPD) within the corrected age of 12 months old after birth. Methods Infants with moderate BPD, who were discharged from Neonatal Intensive Care Unit(NICU) of Lianyungang Maternal and Child Healthcare Hospital Affiliated to Yangzhou University from September 1st, 2016 to September 1st, 2019, were enrolled in this study.All the infants were inhaled with 0.9% sodium chloride(2 ml) and budesonide(1 ml) for 1 month after discharge from hospital.According to the atomization inhalation strategy, infants were randomly divided into three groups: long-term inhalation group(n=11), on-demand inhalation group(n=10) and none-inhalation group(n=10).The effects of atomization inhalation strategy on respiratory tract infection symptoms such as wheezing and fever, frequency of upper respiratory tract infection, pneumonia, times of admission to PICU, and tidal pulmonary function at corrected age of 1 and 12 months were analyzed retrospectively. Results There were no significant differences in frequencies of wheezing, fever and pneumonia, the times of admission to PICU and wheezing after physical activity within one year among long-term inhalation group, on-demand inhalation group and none-inhalation group(P>0.05), but the frequency of upper respiratory tract infection in the long-term inhalation group was significantly reduced(P<0.05).At the correct gestational age of 12 months, there were no significant differences in the tidal volume(VT/kg), inspiratory/expiratory ratio(Ti/Te), ratio of TPEF and TE(TPTEF/TE) and mean exhaled expiratory flow in the period of 75% tidal volume(TEF75) among the three groups(P>0.05).Compared with on-demand inhalation group and non-inhalation group, the ratio of VPEF and VE(VPEF/VE) in the long-term inhalation group was significantly higher at the corrected gestational age of 12 months(F=36.36, P＜0.05).The VPEF/VE at corrected gestational age of 12 months significantly increased than that at corrected gestational age of 1 month in long-term inhalation group(P<0.05). Conclusion Long-term budesonide inhalation strategy reduces the frequency of upper respiratory tract infection and improve VPEF/VE in children with moderate BPD during corrected age of 12 months, but has limited protection against acute aggravation or worsening of respiratory symptoms.

Key words: bronchopulmonary dysplasia, budesonide, aerosol inhalation, long-term effect