The quest for the mechanisms of the sudden infant death syndrome: doubts and progress.
The quest for the mechanisms of the sudden infant death syndrome: doubts and progress.
复制标题
婴儿猝死综合症机制的探索：疑问与进展。
DOI：
10.1161/01.cir.75.4.677
复制
发表时间：
1987
期刊：
影响因子：
37.8
通讯作者：
P. Schwartz
中科院分区：
文献类型：
--
作者：
P. Schwartz
新生儿出生后第一年死亡的主要原因是婴儿猝死综合症，也被称为婴儿床或婴儿床死亡。在大多数国家，它的发病率接近每1000名活产儿中就有2名，尽管在一些国家，例如斯堪的纳维亚国家，发病率明显较低。它通常被定义为任何婴儿或幼儿的突然死亡，这是历史上意想不到的，而且彻底的尸检未能证明充分的死因。由于小岛屿发展中国家的高发病率、对受影响家庭的灾难性影响、围绕这些死亡的谜团以及尚未解决的科学问题，小岛屿发展中国家对当代医学构成了重大挑战。预防特定事件，在这种情况下是猝死，需要对所涉及的机制有充分的了解。关于小岛屿发展中国家，这些机制仍然难以捉摸。在这里，我将讨论小岛屿发展中国家研究中的一些实际困难和方法论问题，并对呼吸和心脏理论进行分析。后者将更详细地介绍，这不是为了反映其更突出的作用，而是反映我的专业领域和我作为其倡导者之一的作用。在小岛屿发展中国家许多耐人寻味的方面中，其中一个当然是关于这一疾病的硬科学数据和软科学数据的混合，对已发表研究的批判性审查证明了这一点。这在很大程度上是因为医学领域非常不寻常地涉及具有如此不同背景的调查人员，以至于感兴趣的受众往往没有必要的专业知识来识别潜在的弱点和确定错误的结论。明显缺乏记录的信息伴随着
THE LEADING CAUSE of mortality during the first year of life, after the neonatal period, is the sudden infant death syndrome (SIDS), also known as cot or crib death.' Its incidence is close to 2 per 1000 live births in most countries, although in some, e.g., the Scandinavian countries, it is markedly lower. It is usually defined as the sudden death of any infant or young child, which is unexpected by history, and in which a thorough postmortem examination fails to demonstrate an adequate cause for death. Because of the high incidence, the catastrophic impact on the affected families, the mystery still surrounding these deaths, and the unsolved scientific problem, SIDS represents a major challenge for contemporary medicine. Prevention of a given event, sudden death in this case, requires an adequate understanding of the mechanisms involved. With regard to SIDS, these mechanisms remain elusive. Here I will discuss some of the actual difficulties and methodologic problems in the research on SIDS and then analyze the respiratory and cardiac theories. The latter will be presented in greater detail, which is not meant to reflect its more prominent role, but rather my area of expertise and my role as one of its proponents.2 A difficult target. Among the many intriguing aspects of SIDS, one certainly is the mixture of hard and soft scientific data on this disorder, as evidenced by critical review of the published studies. This results largely from the involvementquite unusual in medicineof investigators with such diverse backgrounds that all too often the interested audience does not have the expertise necessary to recognize potential weaknesses and to identify wrong conclusions. The remarkable lack of documented information is accompanied by a