Necrotizing enterocolitis in newborns: update in pathophysiology and newly emerging therapeutic strategies.
Necrotizing enterocolitis in newborns: update in pathophysiology and newly emerging therapeutic strategies.
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DOI：
10.3345/kjp.2014.57.12.505
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发表时间：
2014-12-01
影响因子：
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通讯作者：
Choi, Young Youn
中科院分区：
文献类型：
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作者：
Choi, Young Youn
虽然近年来由于先进的呼吸护理，患有呼吸窘迫综合征的极早产儿的存活率有所增加，但坏死性小肠结肠炎（NEC）仍然是新生儿死亡和发病的主要原因。NEC在胎龄较低和出生体重较低的人群中更为普遍。其特征是不同程度的粘膜或透壁性肠坏死。其确切的发病机制尚不清楚，但早产、肠内喂养、细菌产物和肠缺血都已被证明会引起炎症级联反应的激活，这被称为肠损伤的最终共同途径。对NEC风险因素的认识;降低风险的做法，包括早期母乳喂养和遵循既定的喂养指南;以及益生菌的管理已被证明可以降低NEC的发病率。尽管在NEC的病理生理学的知识和理解的进步，目前没有普遍的预防措施，这种严重的，往往是致命的疾病。因此，应该研究新的潜在技术来检测肠道炎症特异性的早期生物标志物或因子，以及预防炎症级联反应激活的进一步策略，这对疾病进展很重要。
While the survival of extremely premature infants with respiratory distress syndrome has increased due to advanced respiratory care in recent years, necrotizing enterocolitis (NEC) remains the leading cause of neonatal mortality and morbidity. NEC is more prevalent in lower gestational age and lower birth weight groups. It is characterized by various degrees of mucosal or transmural necrosis of the intestine. Its exact pathogenesis remains unclear, but prematurity, enteral feeding, bacterial products, and intestinal ischemia have all been shown to cause activation of the inflammatory cascade, which is known as the final common pathway of intestinal injury. Awareness of the risk factors for NEC; practices to reduce the risk, including early trophic feeding with breast milk and following the established feeding guidelines; and administration of probiotics have been shown to reduce the incidence of NEC. Despite advancements in the knowledge and understanding of the pathophysiology of NEC, there is currently no universal prevention measure for this serious and often fatal disease. Therefore, new potential techniques to detect early biomarkers or factors specific to intestinal inflammation, as well as further strategies to prevent the activation of the inflammatory cascade, which is important for disease progression, should be investigated.