ObjectivesTo evaluate the predicting value of bedside pulmonary ultrasound in bronchopulmonary dysplasia (BPD) in premature infants.MethodsPremature infants with gestational age below 28 weeks or birth weight below 1 500 g admitted to NICU of Chengdu Women and Children’s Central Hospital from June 2018 to June 2019 were included. Pulmonary bedside ultrasound monitoring was performed on the 3rd, 7th, 14th and 28th day after admission, and the characteristic ultrasound images were recorded and scored. BPD were diagnosed by NICHD standard. The clinical data and pulmonary ultrasound data were compared and analyzed. Then diagnostic value of bedside pulmonary ultrasound in BPD of premature infants were analyzed.ResultsA total of 81 children involving 32 BPD and 49 non-BPD were included. The sensitivity (Sen), specificity (Spe) and area under curve (AUC) of receiver operating characteristic (ROC) of the "alveolar-interstitial syndrome" within 3 days after birth and the "fragment sign" on 28 days after birth were 81.25%, 51.02%, 0.66 and 31.25%, 97.96%, 0.65, respectively. The lung ultrasound scores in the BPD group on the 3rd, 7th, 14th, and 28th day after birth were 71.99.%, 68.39%, 0.71; 87.50%, 57.14%, 0.72; 78.13%, 73.47%, 0.76 and 56.25 %, 75.51%, 0.66. Sen, Spe and ROC AUC of comprehensive evaluation of lung ultrasound predicted the occurrence of BPD been 81.25%, 63.27%, and 0.85.ConclusionsThe comprehensive evaluation of combination of "alveolar interstitial syndrome" image characteristics within 3 days after birth, "fragment sign" image characteristics after 28 days, and lung ultrasound score at different times after birth can predict the premature infants with bronchopulmonary dysplasia.
ObjectiveTo investigate the clinical risk factors of preterm infants and its severity in premature infants with bronchopulmonary dysplasia (BPD) with retinopathy of prematurity (ROP).MethodsRetrospective clinical study was performed. A total of 126 preterm infants with BPD in the Neonatal Department of the Affiliated Hospital of Qingdao University from January 2016 to December 2018 were enrolled in the study. Among them, 69 were males and 57 were females, whose gestational age＜32 weeks and birth weight＜1500 g. BPD grades Ⅰ, Ⅱ, and Ⅲ were 63, 40, and 23 cases respectively. According to the presence or absence of ROP, children were divided into ROP group and non-ROP group, with 48 (38.1%) and 78 (61.9%) cases respectively. The differences of clinical data between the two groups were compared and analyzed. Quantitative data comparison between groups was performed by t test, and count data comparison was performed by χ2 test. The risk factors of ROP in BPD premature infants were analyzed by multi-factor logistics regression. The correlation between BPD severity and ROP severity was tested by Spearman rank correlation test.ResultsCompared with the non-ROP group, the ROP group had a smaller gestational age (t=5.988), lower birth weight (t=7.371), higher the application rate of oxygen concentration＞30% (duration of service＞24 h), high rate (χ2=17.244) and longer noninvasive ventilation time (t=－7.139), the differences were statistically significant (P＜0.05). In the logistic regression model, the noninvasive ventilation time was the risk factor for ROP in preterm infants with BPD (OR≈1.054, P＜0.05), while gestational age and birth weight were importantly protective factors for ROP in preterm infants with BPD (OR≈0.938, 0.996; P＜0.05). The results of the correlation analysis found that the severity of BPD was significantly positively correlated with the severity of ROP. As the severity of BPD increased, the severity of ROP increased, and the difference was statistically significant (rs=0.306, P＜0.035).ConclusionsFetal gestational age, low birth weight, hyperoxia, and long-term non-invasive mechanical ventilation are the main risk factors for ROP in preterm infants with BPD. The severity of BPD is positively correlated with the incidence and severity of ROP.
Bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) are common and important diseases in preterm infants. What these diseases have in common is altered blood vessel formation and pathological changes in the case of incomplete organ development. Multiple factors interact to cause abnormal angiogenesis, which increases the likelihood of a common pathway for both diseases. However, little is known about the specific mechanism of this balance in the occurrence and development of BPD or ROP, and there are still no animal models to explore the pathogenesis of these two diseases simultaneously. At present, there is no effective prevention program, and the treatment options include drug therapy, surgery, etc. In the future, more studies are needed to find common therapeutic targets for factors affecting angiogenesis, so as to provide a better choice for the treatment of BPD and ROP and improve the effectiveness of the treatment effect.