Abstract：
BACKGROUND: Preterm infants, particularly those with bronchopulmonary dysplasia (BPD), are at risk of lung development problems. Over the last decades, lung protective strategies have been used, decreasing the risk of chronic lung disease.
OBJECTIVE: To evaluate the pulmonary function test (PFT) of preterm infants born after the introduction of lung protective strategies and to assess perinatal determinants of impaired lung function in this population.
METHODS: A prospective, observational, single-center study was conducted in the neonatal unit of a high-complexity hospital. The study included newborns with less than 32 weeks gestational age born between 2012 and 2014, who were followed up until they reach school age. For the main outcome, two groups were stablished: no BPD or grade 1 BPD (no BPD/1) and grade 2 or 3 BPD (BPD 2/3).
RESULTS: Out of 327 patients, 116 were included. BPD was diagnosed in 49.1% (47), with 50.9% (29) classified as grade 1, 35.1% (20) as grade 2, and 14.0% (8) as grade 3. Mean age at PFT was 8.59 years (SD 0.90). Mean FEV1% was 95.36% (SD 13.21) and FEV1 z-score -0.36 (SD 1.12); FVC% 97.53% (SD 12.59) and FVC z-score -0.20 (SD 1.06); FEV1/FVC ratio 85.84% (SD 8.34) and z-score -0.24 (SD 1.34). When comparing patients with no BPD/1 and BPD 2/3, we observed differences in all pulmonary function parameters, which persisted after adjusting for gestational age. No differences in PFT were observed between patients without BPD and those with grade 1 BPD. Most patients (76.7%, 89) had normal spirometry pattern, with obstructive pattern observed in 12.9% (15), restrictive pattern in 9.5% (11), and mixed pattern in 0.9% (1) of patients.
CONCLUSIONS: Preterm infants with BPD 2/3 showed a decrease in all pulmonary function parameters compared to preterm infants with no BPD/1; an effect that was independent of gestational age. Among patients with BPD who had an altered PFT pattern, the most common pattern was obstructive, followed by restrictive and then, mixed.
OBJECTIVE: To evaluate the pulmonary function test (PFT) of preterm infants born after the introduction of lung protective strategies and to assess perinatal determinants of impaired lung function in this population.
METHODS: A prospective, observational, single-center study was conducted in the neonatal unit of a high-complexity hospital. The study included newborns with less than 32 weeks gestational age born between 2012 and 2014, who were followed up until they reach school age. For the main outcome, two groups were stablished: no BPD or grade 1 BPD (no BPD/1) and grade 2 or 3 BPD (BPD 2/3).
RESULTS: Out of 327 patients, 116 were included. BPD was diagnosed in 49.1% (47), with 50.9% (29) classified as grade 1, 35.1% (20) as grade 2, and 14.0% (8) as grade 3. Mean age at PFT was 8.59 years (SD 0.90). Mean FEV1% was 95.36% (SD 13.21) and FEV1 z-score -0.36 (SD 1.12); FVC% 97.53% (SD 12.59) and FVC z-score -0.20 (SD 1.06); FEV1/FVC ratio 85.84% (SD 8.34) and z-score -0.24 (SD 1.34). When comparing patients with no BPD/1 and BPD 2/3, we observed differences in all pulmonary function parameters, which persisted after adjusting for gestational age. No differences in PFT were observed between patients without BPD and those with grade 1 BPD. Most patients (76.7%, 89) had normal spirometry pattern, with obstructive pattern observed in 12.9% (15), restrictive pattern in 9.5% (11), and mixed pattern in 0.9% (1) of patients.
CONCLUSIONS: Preterm infants with BPD 2/3 showed a decrease in all pulmonary function parameters compared to preterm infants with no BPD/1; an effect that was independent of gestational age. Among patients with BPD who had an altered PFT pattern, the most common pattern was obstructive, followed by restrictive and then, mixed.
摘要：
背景：早产儿，特别是那些支气管肺发育不良（BPD），有肺部发育问题的风险。在过去的几十年里，已经使用了肺保护策略，降低慢性肺病的风险。
目的：评估采用肺保护策略后出生的早产儿的肺功能测试（PFT），并评估该人群中肺功能受损的围产期决定因素。
方法：前瞻性，观察,单中心研究在高复杂性医院的新生儿病房进行.该研究包括2012年至2014年出生的胎龄小于32周的新生儿，并对他们进行随访，直到他们达到学龄。对于主要结果，两组均建立：无BPD或1级BPD（无BPD/1）和2级或3级BPD（BPD2/3）。
结果：在327名患者中，116人被包括在内。BPD诊断为49.1%(47)，50.9%（29）被列为一级，35.1%（20）被列为二级，14.0%（8）被列为三级。PFT的平均年龄为8.59岁（SD0.90）。平均FEV1％为95.36％（SD13.21），FEV1z评分为-0.36（SD1.12）；FVC％为97.53％（SD12.59），FVCz评分为-0.20（SD1.06）；FEV1/FVC比率为85.84％（SD8.34），z评分为-0.24（SD1.34）。当比较没有BPD/1和BPD2/3的患者时，我们观察到所有肺功能参数的差异，在调整胎龄后仍然存在。在没有BPD的患者和有1级BPD的患者之间没有观察到PFT的差异。大多数患者（76.7%，89)肺活量测定模式正常，在12.9%(15)中观察到阻塞性模式，限制性模式为9.5%(11)，0.9％（1）的患者混合模式。
结论：与没有BPD/1的早产儿相比，患有BPD2/3的早产儿的所有肺功能参数均下降；这种影响与胎龄无关。在PFT模式改变的BPD患者中，最常见的模式是阻塞，其次是限制性的，然后，混合。
目的：评估采用肺保护策略后出生的早产儿的肺功能测试（PFT），并评估该人群中肺功能受损的围产期决定因素。
方法：前瞻性，观察,单中心研究在高复杂性医院的新生儿病房进行.该研究包括2012年至2014年出生的胎龄小于32周的新生儿，并对他们进行随访，直到他们达到学龄。对于主要结果，两组均建立：无BPD或1级BPD（无BPD/1）和2级或3级BPD（BPD2/3）。
结果：在327名患者中，116人被包括在内。BPD诊断为49.1%(47)，50.9%（29）被列为一级，35.1%（20）被列为二级，14.0%（8）被列为三级。PFT的平均年龄为8.59岁（SD0.90）。平均FEV1％为95.36％（SD13.21），FEV1z评分为-0.36（SD1.12）；FVC％为97.53％（SD12.59），FVCz评分为-0.20（SD1.06）；FEV1/FVC比率为85.84％（SD8.34），z评分为-0.24（SD1.34）。当比较没有BPD/1和BPD2/3的患者时，我们观察到所有肺功能参数的差异，在调整胎龄后仍然存在。在没有BPD的患者和有1级BPD的患者之间没有观察到PFT的差异。大多数患者（76.7%，89)肺活量测定模式正常，在12.9%(15)中观察到阻塞性模式，限制性模式为9.5%(11)，0.9％（1）的患者混合模式。
结论：与没有BPD/1的早产儿相比，患有BPD2/3的早产儿的所有肺功能参数均下降；这种影响与胎龄无关。在PFT模式改变的BPD患者中，最常见的模式是阻塞，其次是限制性的，然后，混合。
