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早产新生儿的氧化应激与营养

Oxidative stress and nutrition in the preterm newborn.

作者信息

Perrone Serafina, Salvi Giulia, Bellieni Carlo V, Buonocore Giuseppe

机构信息

Department of Pediatrics, Obstetrics, and Reproductive Medicine, University of Siena, Italy.

出版信息

J Pediatr Gastroenterol Nutr. 2007 Dec;45 Suppl 3:S178-82. doi: 10.1097/01.mpg.0000302968.83244.d2.

Abstract

Oxidative stress occurs when the production of free radicals exceeds the cells' ability to eliminate them. Many events leading to overproduction of free radicals may easily induce oxidative stress in the earliest phases of human life. Given the growing role of oxidative stress in newborn preterm morbidity, one of the goals of modern neonatology is to minimize free radical production and promote the development of adequate antioxidant systems through an adequate nutritional strategy. Appropriate administration of total parenteral solutions and lipid emulsions with light protection can minimize the risk of peroxidation. Providing the baby with amino acid substrates for cellular glutathione synthesis immediately after birth promotes antioxidant defenses at the early stages of life. Breast milk has been found to have many advantages over formula, including the potential to provide antioxidant protection to infants. It is conceivable that these antioxidants in breast milk help to eliminate free radicals in infants. The role of vitamin administration in preterm nutrition has not yet been established. Clinical trials carried out to test the efficacy of antioxidant drugs or vitamins were inconclusive. At present, there are no evidence-based recommendations about the use of nutritional strategies or antioxidant drugs to minimize oxidative stress in the management of preterm infants.

摘要

当自由基的产生超过细胞清除它们的能力时,就会发生氧化应激。许多导致自由基产生过多的事件很容易在人类生命的最早阶段诱发氧化应激。鉴于氧化应激在新生儿早产发病率中日益增加的作用,现代新生儿学的目标之一是通过适当的营养策略将自由基产生降至最低,并促进适当抗氧化系统的发育。适当给予全胃肠外营养液和具有光保护作用的脂质乳剂可将过氧化风险降至最低。出生后立即为婴儿提供用于细胞内谷胱甘肽合成的氨基酸底物,可在生命早期促进抗氧化防御。已发现母乳相对于配方奶有许多优点,包括有可能为婴儿提供抗氧化保护。可以想象,母乳中的这些抗氧化剂有助于消除婴儿体内的自由基。维生素补充在早产营养中的作用尚未确定。为测试抗氧化药物或维生素的疗效而进行的临床试验尚无定论。目前,关于在早产儿管理中使用营养策略或抗氧化药物以尽量减少氧化应激,尚无基于证据的建议。

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