医学综述
醫學綜述
의학종술
MEDICAL RECAPITULATE
2015年
3期
453-456
,共4页
尹金明(综述)%陈光明%任榕娜(审校)
尹金明(綜述)%陳光明%任榕娜(審校)
윤금명(종술)%진광명%임용나(심교)
宫内感染%炎症%炎症介质%新生儿肺透明膜病
宮內感染%炎癥%炎癥介質%新生兒肺透明膜病
궁내감염%염증%염증개질%신생인폐투명막병
Intrauterine infection%Inflammation%Inflammatory medium%Hyaline membrane disease
新生儿肺透明膜病( HMD)是早产儿呼吸困难和死亡最常见的原因,由于其病死率高、后遗症多,救治此类患儿仍是新生儿科医师面临的严峻挑战。 HMD 发病机制十分复杂,尚未完全阐明。目前认为宫内感染与HMD发病密切相关,孕妇妊娠期间发生感染,胎儿暴露于炎性环境,引起胎儿炎症反应,导致大量炎性细胞聚集,并释放多种炎性介质,炎性介质彼此之间在不同环节上相互作用,形成了非常复杂的炎症网络,感染后多种效应细胞及炎症介质可能是造成HMD发病的“中心环节”,一方面过度的炎症刺激可能阻碍肺泡化进程和肺微血管发育,导致肺损伤和HMD,另一方面适度的炎症反应可能促进肺表面活性物质合成,促进肺成熟。
新生兒肺透明膜病( HMD)是早產兒呼吸睏難和死亡最常見的原因,由于其病死率高、後遺癥多,救治此類患兒仍是新生兒科醫師麵臨的嚴峻挑戰。 HMD 髮病機製十分複雜,尚未完全闡明。目前認為宮內感染與HMD髮病密切相關,孕婦妊娠期間髮生感染,胎兒暴露于炎性環境,引起胎兒炎癥反應,導緻大量炎性細胞聚集,併釋放多種炎性介質,炎性介質彼此之間在不同環節上相互作用,形成瞭非常複雜的炎癥網絡,感染後多種效應細胞及炎癥介質可能是造成HMD髮病的“中心環節”,一方麵過度的炎癥刺激可能阻礙肺泡化進程和肺微血管髮育,導緻肺損傷和HMD,另一方麵適度的炎癥反應可能促進肺錶麵活性物質閤成,促進肺成熟。
신생인폐투명막병( HMD)시조산인호흡곤난화사망최상견적원인,유우기병사솔고、후유증다,구치차류환인잉시신생인과의사면림적엄준도전。 HMD 발병궤제십분복잡,상미완전천명。목전인위궁내감염여HMD발병밀절상관,잉부임신기간발생감염,태인폭로우염성배경,인기태인염증반응,도치대량염성세포취집,병석방다충염성개질,염성개질피차지간재불동배절상상호작용,형성료비상복잡적염증망락,감염후다충효응세포급염증개질가능시조성HMD발병적“중심배절”,일방면과도적염증자격가능조애폐포화진정화폐미혈관발육,도치폐손상화HMD,령일방면괄도적염증반응가능촉진폐표면활성물질합성,촉진폐성숙。
Hyaline membrane disease ( HMD) is the most common reason for dyspnea and death of pre-mature infants,and due to its high case fatality rate and many sequelae ,it′s still a severe challenge for physi-cians of neonatology department to treat children with HMD .The pathogenesis of HMD is very complex and currently not well known.At present,it′s believed that intrauterine infection is closely related to the attack of HMD;if a pregnant woman is infected during pregnancy,the fetus is exposed to inflammatory environment, leading to inflammatory response of the fetus and the accumulation of large amounts of inflammatory cells , which will release various kinds of inflammatory media; the inflammatory media interact with each other at different links to form a very complex inflammation network ,and various kinds of effector cells and inflamma-tory media after inflection may be the “central links” causing HMD:On the one hand,excessive inflammato-ry stimulation may impede the process of alveolarization and the growth of pulmonary capillaries ,resulting in lung injury and HMD; on the other hand,moderate inflammatory response may promote the synthesis of pul-monary surfactant (PS),which promotes the maturity of lung.This paper reviews the role of intrauterine in-flection in HMD.