Neonatal apnea: What's new?
Neonatal apnea: What's new?
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DOI：
10.1002/ppul.20832
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发表时间：
2008-10-01
影响因子：
3.1
通讯作者：
Martin, Richard J.
中科院分区：
文献类型：
--
作者：
Abu-Shaweesh, Jaial M.;Martin, Richard J.
早产儿呼吸暂停（AOP）仍然是当今儿科的一个主要临床问题，需要频繁评估并对治疗策略提出挑战。虽然AOP的发病机制还不清楚，但它可能是呼吸控制生理不成熟的表现，而不是一种病理性疾病。早产儿对缺氧、高碳酸血症和过度抑制性肺反射的不成熟呼吸反应也可能导致AOP的发生或严重程度。最近的数据表明遗传易感性的作用。虽然典型的解决与成熟，心动过缓和去饱和发作与AOP的睡眠障碍呼吸和神经发育迟缓的发展中的作用需要进一步澄清。甲基黄嘌呤和CPAP的药物治疗仍然是治疗AOP的主要方法。然而，最近的研究表明，包括前列腺素、GABA和腺苷在内的中枢抑制性神经调节剂参与了其发病机制，这一事实可能为未来的治疗提供了特定的靶点。本文将总结新的见解，涉及这些问题，以及其他涉及的发病机制，治疗策略和早产儿呼吸暂停的后果。
Apnea of prematurity (AOP) remains a major clinical problem in present day neonatology that warrants frequent evaluations and imposes challenges in therapeutic strategies. Although the pathogenesis of AOP is poorly understood, it is probably a manifestation of physiologic immaturity of breathing control rather than a pathologic disorder Immature breathing responses to hypoxia, hypercapnia and exaggerated inhibitory pulmonary reflexes in preterm infants might also contribute to the occurrence or severity of AOP. Recent data suggest a role for genetic predisposition. Although typically resolve with maturation, the role of bradycardia and desaturation episodes associated with AOP in the development of sleep disorder breathing and neuro-developmental delay needs further clarification. Pharmacological treatment with methylxanthines and CPAP remain the mainstay for treatment of AOP However, recent studies have implicated central inhibitory neuromodulators including prostaglandins, GABA and adenosine in its pathogenesis, the fact that might provide future specific targets for treatment. This review will summarize new insights involving these issues as well as others involving the pathogenesis, treatment strategies and consequences of apnea in premature infants.