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

摘要： 目的 研究不同布地奈德雾化吸入策略对中度支气管肺发育不良(BPD)早产儿生后矫正胎龄12月内生活质量的影响。方法 收集扬州大学附属连云港市妇幼保健院2016年9月1日-2019年9月1日新生儿重症监护室出院的中度BPD患儿31例,采用前瞻性方法,出院后均以 0.9%氯化钠2 ml+布地奈德1 ml雾化吸入 bid×1月。然后根据随机方式,将出院1月后～矫正胎龄12月时雾化吸入策略分为3种:长期吸入组(n=11)、按需吸入组(n=10)及无吸入组(n=10)。分析雾化吸入策略对中度BPD患儿矫正胎龄12月内呼吸道症状如喘息及发热、上感及肺部感染频次、入住儿科重症监护室(PICU)次数及矫正胎龄1月及12月潮气肺功能指标的影响。结果 与按需吸入组及无吸入组相比,长期吸入组患儿1年内发生喘息及发热、肺部感染频次、入住PICU次数及健康状态时活动后气急之间差异均无统计学意义(P＞0.05),但长期吸入组患儿上感次数明显减少(P＜0.05)。31例中度BPD患儿矫正胎龄12月后,三组间潮气量(VT/kg)、 吸呼比(Ti/Te)、达峰时间比(TPTEF/TE)及呼出25%潮气容积时段的平均呼气流量(TEF75)差异均无统计学意义(P＞0.05);与按需吸入组及无吸入组相比,长期吸入组矫正胎龄12月时达峰容积比(VPEF/VE)明显升高(F＝36.36,P＜0.05);长期吸入组矫正胎龄12月VPTEF/VE较1月时明显升高,差异具有统计学意义(P＜0.05)。结论 长期布地奈德吸入策略可减少中度BPD患儿矫正胎龄12月内上呼吸道感染发生频次,改善VPTEF/VE,但对呼吸系统症状急性加重或恶化的保护作用有限。

关键词: 支气管肺发育不良, 布地奈德, 雾化吸入, 长期影响