Haemopoietic colony stimulating factors for preterm neonates
Haemopoietic colony stimulating factors for preterm neonates
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DOI：
10.1136/fn.76.2.f128
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发表时间：
1997-03-01
影响因子：
4.4
通讯作者：
Modi, N
中科院分区：
文献类型：
--
作者：
Carr, R;Modi, N
细菌和真菌败血症是新生儿发病率和死亡率的主要原因。在重症监护病房接受治疗的婴儿感染率很高，感染率最高，约为30%，发生在极不成熟的早产儿中。1-3耶鲁大学自1928年以来一直在进行的一项关于新生儿感染的调查4记录了随着新生儿重症监护病房的建立和越来越有效的抗生素的自由使用，新生儿败血症死亡人数的下降。脓毒症的死亡率在20世纪80年代初之前一直在稳步下降，但自那以来一直保持在近15%的水平。死亡率的这一平台期很可能反映了未成熟、早产儿的宿主防御能力差。5中性粒细胞是抵御细菌感染的中心细胞，6在新生儿中，中性粒细胞的产生和功能都不成熟。中性粒细胞减少，定义为中性粒细胞计数低于Monroe建立的新生儿正常范围，7发生在高达35%的早产儿8.9和50%的妊娠高血压综合征母亲所生婴儿。10败血症合并中性粒细胞减少症的病死率高达39%，中性粒细胞低于0.5万/L的败血症婴儿每三个中就有两个死亡。9.
Bacterial and fungal sepsis is a major cause of morbidity and mortality in neonates. Infection rates are high in infants treated in intensive care units, with the highest rates, of around 30%, occurring in extremely immature preterm neonates. 1–3 A survey of neonatal infection at Yale University, ongoing since 1928, 4 has documented a decline in neonatal septic deaths commensurate with the establishment of neonatal intensive care units and the liberal use of increasingly eVective antibiotics. Mortality from sepsis declined steadily until the early 1980s, but since then it has remained constant at near 15%. This plateau of mortality most likely reflects the poor host defences of immature, preterm neonates. 5 Neutrophil leucocytes are central to the defences against bacterial infection, 6 and in neonates both neutrophil production and function are immature. Neutropenia, defined as a neutrophil count below the normal range for neonates established by Monroe, 7 occurs in up to 35% of preterm neonates8 9 and in 50% of all infants born to mothers with pregnancy induced hypertension. 10 The development of sepsis together with neutropenia carries a high mortality of 39%, and two out of every three septic infants whose neutrophils fall below 0.5× 109/l will die. 9