Department of Pediatrics and Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, FIN-20520 Turku, Finland.
Early Hum Dev. 2009 Oct;85(10):627-9. doi: 10.1016/j.earlhumdev.2009.09.014. Epub 2009 Oct 12.
The pathogenetic cascade of meconium aspiration syndrome (MAS) in newborn infants is complex and still incompletely studied. The variable clinical presentation of MAS is basically connected with variation of the amount and consistency of aspirated meconium and also its distribution within the affected lungs. The contributing role of other factors, like intrauterine fetal compromises, lung maturity at the time of insult as well as direct and indirect effects of meconium and its components on the lung alveolar and vascular integrity and development, remains to be studied in further detail. Better understanding of the lung injury processes in MAS, specifically inflammatory injury and non-inflammatory apoptosis and their interplay, may offer new possibilities to treat the severely affected infants, and needs therefore to be explored. Systemic dispersion of intrapulmonary meconium and its components may further induce inflammatory circulatory changes and injurious effects in distant organs, but the mechanisms and clinical significance of these systemic complications are still poorly known. It is thus evident that lung injury processes and potent long-term consequences in various extrapulmonary organs, specifically the brain, as well as development of new approaches to their treatment and prevention form great challenges for future research of MAS.
胎粪吸入综合征（MAS）在新生儿中的发病机制复杂，仍不完全清楚。MAS 的临床表现多变，主要与吸入胎粪的量和稠度以及其在受累肺部的分布有关。其他因素的作用，如宫内胎儿窘迫、损伤时的肺成熟度，以及胎粪及其成分对肺泡和血管完整性和发育的直接和间接影响，仍需进一步详细研究。更好地理解 MAS 中的肺损伤过程，特别是炎症损伤和非炎症性细胞凋亡及其相互作用，可能为治疗严重受累婴儿提供新的可能性，因此需要进行探索。肺内胎粪及其成分的全身扩散可能进一步在远处器官引起炎症性循环变化和损伤作用，但这些全身并发症的机制和临床意义仍知之甚少。因此，肺部损伤过程以及各种肺外器官（特别是大脑）的潜在长期后果，以及开发针对其治疗和预防的新方法，是 MAS 未来研究的巨大挑战。
